Impact of the COVID-19 pandemic on type 2 diabetes care and factors associated with care disruption in Kenya and Tanzania

Background: The COVID-19 pandemic affected healthcare delivery globally, impacting care access and delivery of essential services. Objectives: We investigated the pandemic’s impact on care for patients with type 2 diabetes and factors associated with care disruption in Kenya and Tanzania. Methods: A cross-sectional study was conducted among adults diagnosed with diabetes pre-COVID-19. Data were collected in February–April 2022 reflecting experiences at two time-points, three months before and the three months most affected by the COVID-19 pandemic. A questionnaire captured data on blood glucose testing, changes in medication prescription and access, and healthcare provider access. Results: We recruited 1000 participants (500/country). Diabetes care was disrupted in both countries, with 34.8% and 32.8% of the participants reporting change in place and frequency of testing in Kenya, respectively. In Tanzania, 12.4% and 17.8% reported changes in location and frequency of glucose testing, respectively. The number of health facility visits declined, 14.4% (p < 0.001) in Kenya and 5.6% (p = 0.001) in Tanzania. In Kenya, there was a higher likelihood of severe care disruption among insured patients (adjusted odds ratio [aOR] 1.56, 95% confidence interval [CI][1.05–2.34]; p = 0.029) and a lower likelihood among patients residing in rural areas (aOR, 0.35[95%CI, 0.22–0.58]; p < 0.001). Tanzania had a lower likelihood of severe disruption among insured patients (aOR, 0.51[95%CI, 0.33–0.79]; p = 0.003) but higher likelihood among patients with low economic status (aOR, 1.81[95%CI, 1.14–2.88]; p = 0.011). Conclusions: COVID-19 disrupted diabetes care more in Kenya than Tanzania. Health systems and emergency preparedness should be strengthened to ensure continuity of service provision for patients with diabetes

Development of mandibular, hyoid and hypobranchial muscles in the zebrafish: homologies and evolution of these muscles within bony fishes and tetrapods

<p>Abstract</p> <p>Background</p> <p>During vertebrate head evolution, muscle changes accompanied radical modification of the skeleton. Recent studies have suggested that muscles and their innervation evolve less rapidly than cartilage. The freshwater teleostean zebrafish (<it>Danio rerio</it>) is the most studied actinopterygian model organism, and is sometimes taken to represent osteichthyans as a whole, which include bony fishes and tetrapods. Most work concerning zebrafish cranial muscles has focused on larval stages. We set out to describe the later development of zebrafish head muscles and compare muscle homologies across the Osteichthyes.</p> <p>Results</p> <p>We describe one new muscle and show that the number of mandibular, hyoid and hypobranchial muscles found in four day-old zebrafish larvae is similar to that found in the adult. However, the overall configuration and/or the number of divisions of these muscles change during development. For example, the undivided adductor mandibulae of early larvae gives rise to the adductor mandibulae sections A0, A1-OST, A2 and Aω, and the protractor hyoideus becomes divided into dorsal and ventral portions in adults. There is not always a correspondence between the ontogeny of these muscles in the zebrafish and their evolution within the Osteichthyes. All of the 13 mandibular, hyoid and hypobranchial muscles present in the adult zebrafish are found in at least some other living teleosts, and all except the protractor hyoideus are found in at least some extant non-teleost actinopterygians. Of these muscles, about a quarter (intermandibularis anterior, adductor mandibulae, sternohyoideus) are found in at least some living tetrapods, and a further quarter (levator arcus palatini, adductor arcus palatini, adductor operculi) in at least some extant sarcopterygian fish.</p> <p>Conclusion</p> <p>Although the zebrafish occupies a rather derived phylogenetic position within actinopterygians and even within teleosts, with respect to the mandibular, hyoid and hypobranchial muscles it seems justified to consider it an appropriate representative of these two groups. Among these muscles, the three with clear homologues in tetrapods and the further three identified in sarcopterygian fish are particularly appropriate for comparisons of results between the actinopterygian zebrafish and the sarcopterygians.</p

Acta Biologica Hungarica 45 1 111 121 HUNGARY

Ultrastructural studies were carried out on the nephron of a euryhaline teleost, Oreochromis niloticus. The nephron consisted of a renal corpuscle, neck segment, bisegmental proximal tubule and a distal tubule. Renal corpuscles displayed a trilaminate structure of fenestrated endothelium, triple layered basement membrane and a highly branched podocyte layer. Neck segments consisted of low cuboidal cells with apical cilia and few vacuoles. Proximal tubules were made up columnar cells with apical brush border. The initial part of the proximal tubule (PI) was characterized by a well developed endocytic apparatus which was absent in the next part (PII). Distal segments comprised of low columnar cells with scanty or no microvilli and an extensive system of basolateral membrane infoldings associated with mitochondria. These findings have been discussed in relation to renal function in fresh water euryhaline teleosts

A Comparison of the Nutritional Quality of Kenya's Omena Fishmeal and Anchovy Fishmeal Fed to Nile Tilapia (Oreochromis Niloticus Linn)

A study was done to determine the apparent digestibility and the nutritional and feeding values of Kenya\'s omena fish meal fed to tilapia Oreochromis niloticus, and to compare them with that of a high quality (LT) anchovy fish meal. Digestibility was assessed using chromic oxide as an external marker. A reference diet was formulated and test diets made by combining 70 % of the reference diet with 30 % of the test ingredients. Each diet was provided to triplicate groups of fish, with 12 fish in each group. Water temperatures and dissolved oxygen concentrations were maintained at 26&#730;C and 5.5 mg L-1 respectively. Faecal collections were done by stripping once a fortnight in the first fifty days and once a week thereafter for three months. Fish performance was assessed at 50 days using weight gain of the fish, specific growth rates and feed conversion ratios. Apparent Digestibility Coefficient for protein (ADC-P) for omena fishmeal was 89.7%, while that of anchovy fish meal was 90 %. These values were not significantly different (P > 0.05). Apparent digestibility coefficients for energy and digestible energy concentrations in omena and anchovy fishmeal were 78 % and 3624 Kcal/kg, and 86 % and 4000 kcal/kg respectively. Feed intakes (grams per fish) were 58, 57.4, 54.9 and 58.1 grams while specific growth rates (% per day) were 0.8, 0.75, 0.69 and 0.72 for fish fed the reference diet and on diets based on omena and anchovy fishmeal and wheat bran respectively. Results of this study indicate that Omena fishmeal compares favorably with anchovy fishmeal in digestibility and utilization by tilapia O. niloticus. The Kenya Veterinarian Vol. 29 2005: pp. 1-

Morphological evaluation of spermatogenesis in Lake Magadi tilapia (Alcolapia grahami): a fish living on the edge

Spermatogenesis in Lake Magadi tilapia (Alcolapia grahami), a cichlid fish endemic to the highly alkaline and saline Lake Magadi in Kenya, was evaluated using light and transmission electron microscopy. Spermatogenesis, typified by its three major phases (spermatocytogenesis, meiosis and spermiogenesis), was demonstrated by the presence of maturational spermatogenic cells namely spermatogonia, spermatocytes, spermatids and spermatozoa. Primary spermatogonia, the largest of all the germ cells, underwent a series of mitotic divisions producing primary spermatocytes, which then entered two consecutive meiotic divisions to produce secondary spermatocytes and spermatids. Spermatids, in turn, passed through three structurally distinct developmental stages typical of type-I spermiogenesis to yield typical primitive anacrosomal spermatozoa of the externally fertilizing type (aquasperm). The spermatozoon of this fish exhibited a spheroidal head with the nucleus containing highly electron-dense chromatin globules, a midpiece containing ten ovoid mitochondria arranged in two rows and a flagellum formed by the typical 9 + 2 microtubule axoneme. In addition, the midpiece, with no cytoplasmic sheath, appeared to end blindly distally in a lobe-like pattern around the flagellum; a feature that was unique and considered adaptive for the spermatozoon of this species to the harsh external environment. These observations show that the testis of A. grahami often undergoes active spermatogenesis despite the harsh environmental conditions to which it is exposed on a daily basis within the lake. Further, the spermiogenic features and spermatozoal ultrastructure appear to be characteristic of Cichlidae and, therefore, may be of phylogenetic significance