Bio-Efficacy of Insecticide-Treated Bednets (ITNs) Distributed through the Healthcare Facilities in a Boundary Community in Nigeria

This study was conducted to evaluate the susceptibility and efficacy of three insecticidal treated bednets; Olyset®, PermaNet2.0® and MAGNet® collected from the different health facilities, against Anopheles mosquitoes under laboratory conditions. PermaNet3.0 was used as a positive control. Larval collections were carried out and reared at the insectary of National Arbovirus and Vector Research Centre, Enugu State. Anopheles Kisumu mosquitoes were used as the standard control in the cone bioassay test. The bioassay showed that the wild An. gambiae s.l. and An. gambiae Kisumu strains were susceptible (100% mortality) to the PermaNet3.0® used as positive control while the wild-caught Anopheles were resistant to the mono-treated ITNs. The mortality effect of the net brands showed that the brands have a statistically significant effect on the mosquito mortality after 24 hours F (2, 18) = 14.32, p < .001), while the sides of the net did not have a statistically significant effect on the mosquito mortality (F (3, 18) = 1.67, p = .209). This study also suggests the need to develop and adopt routine monitoring of the ITNs at the health facilities, as it will inform the replacement of ineffective nets. However, a mass campaign of PBO nets is necessary for the state to achieve and maintain the universal coverage of ITNs

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Background: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. // Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. // Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. // Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

ICT TOOLS AND THEIR UTILIZATION IN ACCESSING AGRICULTURAL INFORMATION AMONG SMALLHOLDER FARMERS IN RURAL AREAS OF SOUTHEAST NIGERIA

Although many studies have been done on ICT usage, most did not explain how effective are some of these ICT tools in accessing not only market information but information on inputs. This article identified the effectiveness of different ICT tools being used by farmers to fetch different information on agricultural activities and other constraining factors that affect the effective use of ICT tools in accessing information apart from socio-economic constraints. The study used structured questionnaires to collect primary data from 360 smallholder farmers. Data were analyzed using descriptive statistics and factor analysis. The study revealed that averagely mobile phone has a mean of 4.29 which was an indication that despite other ICT tools listed for the survey, smallholder farmers in rural area perceived mobile phone more effective in accessing information on agricultural activities. Inadequate human resources, lack of social influence, high cost of repairing, high operation cost, cost of ICTs component, cost of maintenance and problem of theft and general insecurity were other constraining factor that influences ICT use. To reduce some of the hindrance to effective use of ICT especially mobile phone in getting information on new improved varieties which appear to be very important for agricultural sustainability, this study recommends that government and nongovernmental organization should support rural farmer to boost their access to the use of ICT tools. This can be achieved by providing rural farmer with financial aid, subsidizing cost of ICT component as this would reduce the cost of maintaining ICT tools.