Detection Rats Technology for Diagnosis of Tuberculosis in High-Risk Populations

Prevalence of tuberculosis (TB) in prisoners in Tanzania and other sub-Saharan African countries is considered to be higher than in other populations thus prisons are important source of TB transmission. Control of TB in prisons through appropriate screening and diagnosis is challenging in most low-income countries such as Tanzania that is among world’s 22 countries with high burden of TB. Commonly used TB diagnostic test (smear microscopy) have low sensitivity, and most advanced GeneXpert method is rather expensive for developing countries. SUA-APOPO TB detection rats’ technology is most promising and increases TB case detection by over 40% in hospitals in Dar es Salaam Tanzania and Maputo Mozambique. This paper reports on improved TB detection in a selected prison in Tanzania using TB detection rats. Sputum samples (n = 11,424) were collected from 5,840 patients whom 3,491 were men, 2,349 were women. Of these, 386 patients were children altogether seeking diagnosis of TB at Ukonga prison dispensary from January 2013 to October 2015) and Keko prison dispensary from February to October 2015). Samples were routinely examined by Ziehl Neelsen (ZN) staining and later tested by rats APOPO TB laboratory, Sokoine University of Agriculture, Morogoro. Rats’ positive samples were concentrated and confirmed by fluorescent microscopy (LED-FM) or ZN microscopy. A total of 709 individuals (12%) were diagnosed as smearpositive TB by the prison hospital, whereas rats detected an additional 302 TB patients. This increased the case detection in the prison population by 43%. The use of rats’ technology increased the prevalence of smear-positive TB in prisons from 12% to 17.3% (n = 1,011) that is higher than prevalence reported in prisons elsewhere using microscopy. This finding shows that detection rats’ technology can help reduce the burden of TB in developing countries. There is need to expand application of this technology to other risk populations including miners.This technology can improve workforce, livelihood and socio-economy by reducing TB related expenses

Regeneration and carboxymethylation of cellulose and its derivatives: application assessment for brewery wastewater treatment

This research article published by Springer Nature Switzerland AG., 2021Coagulation–flocculation technique is usually employed in wastewater treatment by applying conventional inorganic materials such as alum and ferric chloride. Due cost to environmental challenges associated with the use of inorganic flocculants, biopolymers are gaining ground as alternative water treatment materials. In the present study, native cellulose and hemicelluloses isolated from sugarcane bagasse were used in the removal of turbidity and biological oxygen demand from industrial wastewater. Isolated native cellulose was modified to form regenerated cellulose (RC). Also, native cellulose, hemicellulose and RC were carboxymethylated using Na-chloroacetate. Thereafter, the functional groups on the carboxymethylated biopolymers were examined using Fourier transform infrared spectroscopy and the carbon–hydrogen–nitrogen–sulfur–oxygen elemental analysis. The degree of substitution (DS) for regenerated and carboxymethylated cellulosic materials was measured using recommended standard methods. Carboxymethyl cellulose (CMC) with 1.3 DS reduced turbidity and biological oxygen demand by 62.2 and 64%, respectively. Carboxymethyl regenerated cellulose (CMC-II) at 1.1 DS reduced turbidity and by 55.6 and 60%, respectively. Carboxymethyl hemicellulose (CMH) with 1.4 DS was capable of reducing turbidity and biological oxygen demand by 45.7 and 47%, respectively. Carboxymethyl cellulose and hemicellulose have rarely been used in the treatment of brewery wastewater. In the present study, these two novel materials showed a good prospect in removing biological oxygen demand and turbidity

Microplastics in agriculture – a potential novel mechanism for the delivery of human pathogens onto crops

Mulching with plastic sheeting, the use of plastic carriers in seed coatings, and irrigation with wastewater or contaminated surface water have resulted in plastics, and microplastics, becoming ubiquitous in agricultural soils. Once in the environment, plastic surfaces quickly become colonised by microbial biofilm comprised of a diverse microbial community. This so-called ‘plastisphere’ community can also include human pathogens, particularly if the plastic has been exposed to faecal contamination (e.g., from wastewater or organic manures and livestock faeces). The plastisphere is hypothesised to facilitate the survival and dissemination of pathogens, and therefore plastics in agricultural systems could play a significant role in transferring human pathogens to crops, particularly as microplastics adhering to ready to eat crops are difficult to remove by washing. In this paper we critically discuss the pathways for human pathogens associated with microplastics to interact with crop leaves and roots, and the potential for the transfer, adherence, and uptake of human pathogens from the plastisphere to plants. Globally, the concentration of plastics in agricultural soils are increasing, therefore, quantifying the potential for the plastisphere to transfer human pathogens into the food chain needs to be treated as a priority

Comparison of Bioavailability Between the Most Available Generic Tablet Formulation Containing Artemether and Lumefantrine on the Tanzanian Market and the Innovator's Product.

Existence of anti-malarial generic drugs with low bioavailability marketed on sub-Saharan Africa has raised a concern on patients achieving therapeutic concentrations after intake of these products. This work compared bioavailability of one generic tablet formulation with innovator's product. Both were fixed dose combination tablet formulations containing artemether and lumefantrine.MethodologyThe study was conducted in Dar Es Salaam, Tanzania, in which a survey of the most abundant generic containing artemether-lumefantrine tablet formulation was carried out in retail pharmacies. The most widely available generic (Artefan(R), Ajanta Pharma Ltd, Maharashtra, India) was sampled for bioavailability comparison with Coartem(R) (Novartis Pharma, Basel, Switzerland) - the innovator's product. A randomized, two-treatment cross-over study was conducted in 18 healthy Tanzanian black male volunteers. Each volunteer received Artefan(R) (test) and Coartem(R) (as reference) formulation separated by 42 days of drug-free washout period. Serial blood samples were collected up to 168 hours after oral administration of a single dose of each treatment. Quantitation of lumefantrine plasma levels was done using HPLC with UV detection. Bioequivalence of the two products was assessed in accordance with the US Food and Drug Authority (FDA) guidelines. The most widely available generic in pharmacies was Artefan(R) from India. All eighteen enrolled volunteers completed the study and both test and reference tablet formulations were well tolerated. It was possible to quantify lumefantrine alone, therefore, the pharmacokinetic parameters reported herein are for lumefantrine. The geometric mean ratios for Cmax, AUC0-t and AUC0-[infinity] were 84% in all cases and within FDA recommended bioequivalence limits of 80% -- 125%, but the 90% confidence intervals were outside FDA recommended limits (CI 49--143%, 53 - 137%, 52 - 135% respectively). There were no statistical significant differences between the two formulations with regard to PK parameters (P > 0.05). Although the ratios of AUCs and Cmax were within the acceptable FDA range, bioequivalence between Artefan(R) and Coartem(R) tablet formulations was not demonstrated due to failure to comply with the FDA 90 % confidence interval criteria. Based on the observed total drug exposure (AUCs), Artefan(R) is likely to produce a similar therapeutic response as Coartem(R)

Psychological Distress Among Ethnically Diverse Participants From Eastern and Southern Africa

IMPORTANCE: Psychological distress is characterized by anxiety and depressive symptoms. Although prior research has investigated the occurrence and factors associated with psychological distress in low- and middle-income countries, including those in Africa, these studies' findings are not very generalizable and have focused on different kinds of population groups. OBJECTIVE: To investigate the prevalence and characteristics (sociodemographic, psychosocial, and clinical) associated with psychological distress among African participants. DESIGN, SETTING, AND PARTICIPANTS: This case-control study analyzed data of participants in the Neuropsychiatric Genetics in African Populations-Psychosis (NeuroGAP-Psychosis) study, which recruited from general outpatient clinics in Eastern (Uganda, Kenya, and Ethiopia) and Southern (South Africa) Africa. Individuals who participated in the control group of NeuroGAP-Psychosis from 2018 to 2023 were analyzed as part of this study. Data were analyzed from May 2023 to January 2024. MAIN OUTCOMES AND MEASURES: The prevalence of psychological distress was determined using the Kessler Psychological Distress Scale (K10), which measures distress on a scale of 10 to 50, with higher scores indicating more distress. Participants from the NeuroGAP-Psychosis study were categorized into cases as mild (score of 20-24), moderate (score of 25-29), and severe (score of 30-50), and participants with scores less than 20 were considered controls. Factors that were associated with psychological distress were examined using binomial logistic regression. RESULTS: From the data on 21 308 participants, the mean (SD) age was 36.5 (11.8) years, and 12 096 participants (56.8%) were male. The majority of the participants were married or cohabiting (10 279 participants [48.2%]), most had attained secondary education as their highest form of learning (9133 participants [42.9%]), and most lived with their families (17 231 participants [80.9%]). The prevalence of mild, moderate, and severe psychological distress was 4.2% (869 participants), 1.5% (308 participants), and 0.8% (170 participants), respectively. There were 19 961 participants (93.7%) who served as controls. Binomial logistic regression analyses indicated that the independent associations of psychological distress were experience of traumatic events, substance use (alcohol, tobacco, or cannabis), the physical comorbidity of arthritis, chronic neck or back pain, and frequent or severe headaches. CONCLUSIONS AND RELEVANCE: In this case-control study among ethnically diverse African participants, psychological distress was associated with traumatic stress, substance use, and physical symptoms. These findings were observed to be consistent with previous research that emphasizes the importance of traumatic events as a factor associated with risk for psychopathology and notes the frequent co-occurrence of conditions such as physical symptoms, depression, and anxiety

A SYSTEMATIC REVIEW OF BRIEF NEUROPSYCHOLOGICAL TESTS IN USE AMONG PATIENTS WITH PSYCHOTIC DISORDERS IN LOW AND MIDDLE INCOME COUNTRIES.

Introduction: Assessment of cognitive impairment is recommended as part of the comprehensive care of psychotic disorders. Brief neuropsychological assessments are particularly needed in low resource settings, but few reviews have focused on work done in this context. We aimed to undertake a systematic review of work done in low- and middle-income countries on brief neuropsychological assessments of cognitive impairment in psychotic disorders. Method: A systematic review was performed following PRISMA guidelines. We searched PubMed, Embase and PsycINFO for articles in which a brief neuropsychological test was used to assess cognitive impairment in patients with psychotic disorders in a low- and middle- income country (LMIC) context. Data on whether tests had been validated against the gold standard was abstracted. Data was also abstracted on the tests used, the domains assessed, personnel performing the tests, duration of tests and were abstracted. Results: A total of 29 articles met the inclusion criteria; these studied 3,184 participants with psychosis and 1,261 controls. No test was validated against a gold standard such as the MATRICS consensus cognitive battery. There was marked variability in the tests used, but most were delivered using pen and paper and assessed for cognitive impairment in the reasoning and problem solving domain. All but two publications used highly skilled personnel to perform the assessments. Conclusion: Although a few studies have focused on neuropsychological assessment of cognitive impairment in psychotic disorders in the LMIC context, none compared a brief neuropsychological test with a gold standard. Further work is therefore needed to determine the validity of brief neuropsychological assessment of cognitive impairment in psychotic disorders in these settings