Utilization of PMTCT services at Juba Teaching Hospital, South Sudan

Objective: To determine the uptake of PMTCT services by mothers attending postnatal services at Juba Teaching Hospital.Study Design: A cross-sectional study conducted at the Mother and Child Health (MCH) clinic between May and August 2012Results: All 300 women recruited had at least one antenatal care visit and 246 (82%) received antenatal counselling for HIV: 201 (67%) were tested and 15 (7.5%) were positive. Thirteen of these HIV positive mothers delivered in a health facility. CD4 tests were not done. Three mothers were put on single dose Nevirapine and two on a more efficacious ARV combination, the rest did not receive an ARV. Ten of HIV exposed infants received Nevirapine after delivery. Not all of the HIV-exposed babies were tested by polymerase chain reaction/deoxyribonucleic acid (PCR/DNA). Six babies were on exclusive breastfeeding for the first six months with four on formula and five on mixed feeding. Six mothers were not using any mode of family planning, one used condoms, one had an IUCD and one used dates (natural) method.Conclusion: Although the majority of the mothers received HIV counselling during the antenatal period less than 70% were tested for HIV. CD4 count testing was not routinely done and the use of HAART and other more efficacious ARV combinations were rarely used. DNA/PCR was not routinely done for HIV exposed infants. Safe infant feeding practices were limited. A majority of those with HIV positive partners did not practice safe family planning methods

Comparing Empirical with Perceived Trends in Wildlife, Livestock, Human Population and Settlement Numbers in Pastoral Systems: The Greater Maasai Mara Ecosystem, Kenya

Human activities are driving wildlife population declines worldwide. However, empirical understandings of their operation and consequences for wildlife populations and habitats are limited. We explored relationships between empirical and perceived wildlife and livestock population trends in Kenya using data on i) aerial monitoring of wildlife and livestock populations during 1977-2018, ii) human population censuses; and iii) semi-structured interviews with 338 male and female respondents from 250 households from four zones of the Greater Maasai Mara Ecosystem in 2019 and 2020. Wildlife numbers declined by 72.3% but sheep and goats increased by 306.4%. Yet nearly 50% of the interviewees perceived increases in wildlife numbers during 2011-2020 but concurrent decreases in livestock numbers because wildlife compete with livestock for resources. About one third of the respondents perceived an increase in the number of people living within conservancies and around the reserve and considered this indicative of a developing and thriving community. Notable discrepancies between the empirical and perceived trends were often more apparent than real and collectively suggest that incentives that promote wildlife are evidently viewed as less attractive than those that encourage increasing human and livestock numbers. Reconciling such apparent contradictions in empirical and perceived patterns is essential to extracting insights for formulating policies for sustaining livestock and wildlife populations and their habitats while promoting human welfare in grasslands

Spatiotemporal dynamics of wild herbivore species richness and occupancy across a savannah rangeland:Implications for conservation

Private lands are critical for maintaining biodiversity beyond protected areas. Across Kenyan rangelands, wild herbivores frequently coexist with people and their livestock. Human population and livestock numbers are projected to increase dramatically over the coming decades. Therefore, a better understanding of wildlife-livestock interactions and their consequences for biodiversity conservation on private lands is needed. We used a Bayesian hierarchical, multi-species and multi-year occupancy model on aerial survey data of 15 wild-herbivore species, spanning 15 years (2001–2016) to investigate a) spatiotemporal trends in species occurrence and richness across a mosaic of properties with different land uses in Laikipia County, central Kenya; and b) the effects of distance to water, vegetation and livestock relative abundance on species occurrence and richness. Although mean herbivore species richness varied little over time, we observed high spatial variation in species occurrence across Laikipia, mainly driven by negative effects of high livestock relative abundance. As expected, ‘wildlife friendly’ properties had higher herbivore species richness than other areas. However, high variability suggests that some pastoral properties support rich herbivore communities. The area occupied by five species with global conservation concerns (reticulated giraffe, Grevy's zebra, Beisa Oryx, Defassa waterbuck and gerenuk) and for which Laikipia County is one of the last refuges was <50% across years. We conclude that ‘wildlife friendly’ properties remain crucial for conservation, although some pastoralist areas offer suitable habitats for wild herbivores. Effective management of stocking rates is critical for maintaining ecosystems able to sustain livestock and wildlife on private lands, ensuring protection for endangered species

Cross-boundary human impacts compromise the Serengeti-Mara ecosystem

Protected areas provide major benefits for humans in the form of ecosystem services, but landscape degradation by human activity at their edges may compromise their ecological functioning. Using multiple lines of evidence from 40 years of research in the Serengeti-Mara ecosystem, we find that such edge degradation has effectively “squeezed” wildlife into the core protected area and has altered the ecosystem’s dynamics even within this 40,000-square-kilometer ecosystem. This spatial cascade reduced resilience in the core and was mediated by the movement of grazers, which reduced grass fuel and fires, weakened the capacity of soils to sequester nutrients and carbon, and decreased the responsiveness of primary production to rainfall. Similar effects in other protected ecosystems worldwide may require rethinking of natural resource management outside protected areas

Uganda's experience in Ebola virus disease outbreak preparedness, 2018-2019.

BACKGROUND: Since the declaration of the 10th Ebola Virus Disease (EVD) outbreak in DRC on 1st Aug 2018, several neighboring countries have been developing and implementing preparedness efforts to prevent EVD cross-border transmission to enable timely detection, investigation, and response in the event of a confirmed EVD outbreak in the country. We describe Uganda's experience in EVD preparedness. RESULTS: On 4 August 2018, the Uganda Ministry of Health (MoH) activated the Public Health Emergency Operations Centre (PHEOC) and the National Task Force (NTF) for public health emergencies to plan, guide, and coordinate EVD preparedness in the country. The NTF selected an Incident Management Team (IMT), constituting a National Rapid Response Team (NRRT) that supported activation of the District Task Forces (DTFs) and District Rapid Response Teams (DRRTs) that jointly assessed levels of preparedness in 30 designated high-risk districts representing category 1 (20 districts) and category 2 (10 districts). The MoH, with technical guidance from the World Health Organisation (WHO), led EVD preparedness activities and worked together with other ministries and partner organisations to enhance community-based surveillance systems, develop and disseminate risk communication messages, engage communities, reinforce EVD screening and infection prevention measures at Points of Entry (PoEs) and in high-risk health facilities, construct and equip EVD isolation and treatment units, and establish coordination and procurement mechanisms. CONCLUSION: As of 31 May 2019, there was no confirmed case of EVD as Uganda has continued to make significant and verifiable progress in EVD preparedness. There is a need to sustain these efforts, not only in EVD preparedness but also across the entire spectrum of a multi-hazard framework. These efforts strengthen country capacity and compel the country to avail resources for preparedness and management of incidents at the source while effectively cutting costs of using a "fire-fighting" approach during public health emergencies

Utilization of PMTCT services at Juba Teaching Hospital, South Sudan

Objective: To determine the uptake of PMTCT services by mothers attending postnatal services at Juba Teaching Hospital. Study Design: A cross-sectional study conducted at the Mother and Child Health (MCH) clinic between May and August 2012 Results: All 300 women recruited had at least one antenatal care visit and 246 (82%) received antenatal counseling for HIV: 201(67%) were tested and 15 (7.5%) were positive. Thirteen of these HIV positive mothers delivered in a health facility. CD4 tests were not done. Three mothers were put on single dose Nevirapine and two on a more efficacious ARV combination, the rest did receive an ARV. Ten of HIV exposed infants received Nevirapine after delivery. Not all of the HIV-exposed babies were tested by polymerase chain reaction/deoxyribonucleic acid (PCR/DNA). Six babies were on exclusive breastfeeding for the first six months with four on formula and five on mixed feeding. Six mothers were not using any mode of family planning, one used condoms, one had an IUCD and one used dates (natural) method. Conclusion: Although the majority of the mothers received HIV counseling during the antenatal period less than 70% were tested for HIV. CD4 count testing was not routinely done and the use of HAART and other more efficacious ARV combinations were rarely used. DNA/PCR was not routinely done for HIV exposed infants. Safe infant feeding practices were limited. A majority of those with HIV positive partners did not practice safe family planning methods

Virtual Reality for Addressing Depression and Anxiety: A Bibliometric Analysis

Virtual reality is an emerging field in mental health and has gained widespread acceptance due to its potential to treat various disorders, such as anxiety and depression. This paper presents a bibliometric analysis of virtual reality (VR) use in addressing depression and anxiety from 1995 to 2022. The study analysed 1872 documents using the Scopus database, identifying the field’s most relevant journals and authors. The results indicate that using VR for addressing anxiety and depression is a multidisciplinary field with a wide variety of research topics, leading to significant collaborative research in this area. The Annual Review of Cybertherapy and Telemedicine was identified as the most relevant journal, while Behavior Research and Therapy was found to be the most cited journal. The analysis of keywords suggests that there is more research on using VR for anxiety and related disorders than for depression. Riva G. was identified as the top author in producing research outputs on VR-AD, and the University of Washington emerged as the leading institution in scientific outputs on VR-AD. Thematic and intellectual analyses helped identify the main themes within the research domain, providing valuable insight into the current and future directions of the field

Comparing Empirical with Perceived Trends in Wildlife, Livestock, Human Population and Settlement Numbers in Pastoral Systems: The Greater Maasai Mara Ecosystem, Kenya

Human activities are driving wildlife population declines worldwide. However, empirical understandings of their operation and consequences for wildlife populations and habitats are limited. We explored relationships between empirical and perceived wildlife and livestock population trends in Kenya using data on i) aerial monitoring of wildlife and livestock populations during 1977-2018, ii) human population censuses; and iii) semi-structured interviews with 338 male and female respondents from 250 households from four zones of the Greater Maasai Mara Ecosystem in 2019 and 2020. Wildlife numbers declined by 72.3% but sheep and goats increased by 306.4%. Yet nearly 50% of the interviewees perceived increases in wildlife numbers during 2011-2020 but concurrent decreases in livestock numbers because wildlife compete with livestock for resources. About one third of the respondents perceived an increase in the number of people living within conservancies and around the reserve and considered this indicative of a developing and thriving community. Notable discrepancies between the empirical and perceived trends were often more apparent than real and collectively suggest that incentives that promote wildlife are evidently viewed as less attractive than those that encourage increasing human and livestock numbers. Reconciling such apparent contradictions in empirical and perceived patterns is essential to extracting insights for formulating policies for sustaining livestock and wildlife populations and their habitats while promoting human welfare in grasslands

Extreme wildlife declines and concurrent increase in livestock numbers in Kenya: What are the causes?

There is growing evidence of escalating wildlife losses worldwide. Extreme wildlife losses have recently been documented for large parts of Africa, including western, Central and Eastern Africa. Here, we report extreme declines in wildlife and contemporaneous increase in livestock numbers in Kenya rangelands between 1977 and 2016. Our analysis uses systematic aerial monitoring survey data collected in rangelands that collectively cover 88% of Kenya’s land surface. Our results show that wildlife numbers declined on average by 68% between 1977 and 2016. The magnitude of decline varied among species but was most extreme (72–88%) and now severely threatens the population viability and persistence of warthog, lesser kudu, Thomson’s gazelle, eland, oryx, topi, hartebeest, impala, Grevy’s zebra and waterbuck in Kenya’s rangelands. The declines were widespread and occurred in most of the 21 rangeland counties. Likewise to wildlife, cattle numbers decreased (25.2%) but numbers of sheep and goats (76.3%), camels (13.1%) and donkeys (6.7%) evidently increased in the same period. As a result, livestock biomass was 8.1 times greater than that of wildlife in 2011–2013 compared to 3.5 times in 1977–1980. Most of Kenya’s wildlife (ca. 30%) occurred in Narok County alone. The proportion of the total “national” wildlife population found in each county increased between 1977 and 2016 substantially only in Taita Taveta and Laikipia but marginally in Garissa and Wajir counties, largely reflecting greater wildlife losses elsewhere. The declines raise very grave concerns about the future of wildlife, the effectiveness of wildlife conservation policies, strategies and practices in Kenya. Causes of the wildlife declines include exponential human population growth, increasing livestock numbers, declining rainfall and a striking rise in temperatures but the fundamental cause seems to be policy, institutional and market failures. Accordingly, we thoroughly evaluate wildlife conservation policy in Kenya. We suggest policy, institutional and management interventions likely to succeed in reducing the declines and restoring rangeland health, most notably through strengthening and investing in community and private wildlife conservancies in the rangelands