New Findings on Epidemiology and Management of Rice Yellow Mottle Virus Disease in the Southern Highlands of Tanzania

Three studies were conducted at Kyela district with the objective of adding knowledge on epidemiology and management of rice yellow mottle virus disease. The contribution of different weed management practices on disease transmission and effectiveness of Alvirus (C14H21O3N2), a botanical pesticide in disease control were each evaluated in a randomized complete block experimental design with three replications under two lowland and one upland rice cultures. Twenty elite rice genotypes were also evaluated for resistance to the virus and farmer acceptance in the same sites and on station at Kikusya upland ecology. The results indicated that the first hand weeding in seed broadcasted plots (farmer practice) led to 90% increase in disease incidence compared to 6% and 2% with hand hoe weeding in row planting and use of herbicides (Rilo 250EC 1.5l/ha and 2-4Damine4l/ha) respectively. Use of the latter resulted in 70 – 90% reduction of disease incidence and yield increase of 1.3 to 1.8t/ha or monetary gain of Tsh 614,000/= per hectare on average. Alongside capacity building, these practices were recommended to primary stakeholders. Alvirus achieved 100% disease control when used to soak seed 24 hours prior to planting followed by spraying 14 and 21 days after emergence or where only spraying was used. This new finding was useful for research purposes but warranted further studies to enhance applicability. Existence of differences in pathogen strains was evident between the locations where the genotypes were planted but nine appeared resistant across locations out of which 5 were new, highly acceptable and required promotion to farmers

East African HIV care: depression and HIV outcomes.

Importance:Depression is a common co-morbidity for people living with HIV (PLWH) and is associated with elevated plasma HIV RNA levels. While depression correlates with deficits in antiretroviral (ARV) adherence, little data exist to inform the relationship between depression and HIV vial load more broadly. Objective:To examine the relationship between depression and viral load in the African Cohort Study (AFRICOS) independently of ARV adherence. Design:PLWH in Kenya, Uganda and Tanzania underwent screening for depression using the Center for Epidemiologic Studies Depression Scale (CESD) upon enrollment at AFRICOS HIV care sites. Setting:AFRICOS is an ongoing prospective longitudinal cohort study enrolling HIV-infected adults at HIV care centers including sites in Kenya, Tanzania and Uganda. These sites are administered by President's Emergency Plan For AIDS Relief programs. Participants:HIV+ individuals were eligible if they were at least 18 years old, receiving HIV care at the enrolling clinic and consented to data and specimen collection. Main outcome measure:CESD. Results:Among 2307 participants, 18-25% met the CESD threshold for depression. Depression was associated with decreased ARV adherence (OR 0.59, p =  0.01). Higher scores on three CESD items were significantly associated with 209-282% higher viral load, independently of ARV adherence among participants on ARVs ⩾6 months. Conclusions:PLWH had high prevalence of depression on the CESD. Diverse depression symptoms were independently associated with increases in viral load, underscoring the need for comprehensive treatment of depression

Evaluation and Deployment of Rice Genotypes Resistant to Rice Yellow Mottle Virus Disease in the Southern Highlands of Tanzania

Rice yellow mottle virus (RYMV) is the most important biotic stress undermining productivity of the crop envisaged to spur economic growth and improvement of livelihoods in Tanzania. In efforts to exploit economic and ecofriendly natural host resistance for sustained disease management, reactions of 60 promising rice genotypes selected from various germplasm to a mixture of isolates of the virus under artificial inoculation in the Southern highlands zone represented by Kyela district were studied. Twenty of the most promising entries were further verified on farm at two lowland rainfed and two upland ecologies in the district. Resistance or susceptibility of the genotypes was determined by severity of symptoms as scored on a standard international evaluation scale ranging from 1 to 9 and plant height reduction measured as the difference in height between inoculated and uninoculated plants. Results indicated that RYMV isolates used differed by their virulence and the varieties by their vertical resistance. Observed reactions ranged from highly susceptible to highly resistant. About 50% of the genotypes showed a high level of resistance while 20% were highly susceptible. The intermediate reactions were 0% resistant, 10% susceptible and 20% moderately resistant. Susceptible cultivars recorded up to 75% reduction in height and death of plants whereas those resistant had mild symptoms and negligible plant height reduction. Highly resistant genotypes were immune to infection by the virus across all locations. Five of the highly resistant cultivars namely Salama M55, M57, M19, M35, IITA 235 were acceptable to farmers in terms of cycle length, plant and grain types. Further research to enable official release for commercial use and wide scale accessibility of seed to farmers was deemed necessary to ease damage from RYMV. The varieties can also be deployed as sources of resistance in cross breeding programmes to improve the local susceptible cultivars whose background is already acceptable to farmers. Exhaustive screening of germplasm collections to identify diverse sources of novel genes for resistance was also recommended together with verification of high resistance of genotypes across regions

Combining parenting and economic strengthening programmes to reduce violence against children: a cluster randomised controlled trial with predominantly male caregivers in rural Tanzania caregivers

Introduction: Parenting programmes may reduce risk of violence against children and improve child wellbeing. However, additional economic support may be necessary in highly-deprived rural communities in sub-Saharan Africa. Furthermore, delivering programmes within farmer groups may increase male caregiver recruitment and engagement. Methods: A parallel cluster randomised controlled trial examined the combined and separate effects of parenting and economic strengthening programmes on reducing violence against children ages 0 to 18 years in farming communities in Tanzania (N=248 families; 63% male caregivers). Eight villages were randomly assigned to four conditions (2:2:2:2): 1) 12-session parenting programme (N=60); 2) agribusiness training (N=56); 3) parenting and agribusiness combined (N=72); 4) control (N=60). Parent-report, child-report, and early childhood observation assessments were conducted at baseline, mid-treatment, and post-treatment. Primary outcomes were child maltreatment and parenting behaviour. Secondary outcomes included corporal punishment endorsement, parenting stress, parent/child depression, child behaviour, economic wellbeing, and child development (ClinicalTrials.gov: NCT02633319). Results: At post-treatment, parents and children receiving the combined interventions reported less maltreatment (parents: IRR=0.40, 95%CI [0.24,0.65]; children: IRR=0.40, 95%CI [0.17,0.92]). Parents reported reduced endorsement of corporal punishment (Dw=-0.43, 95%CI [-0.79,0.07]) and fewer child behaviour problems (Dw=-0.41, 95%CI [-0.77,-0.05]). Parents in parenting-only villages reported less abuse (IRR=0.36, 95%CI [0.21,0.63]) and fewer child behaviour problems (Dw=-0.47, 95%CI [-0.84,-0.11]). Parents in agribusiness-only villages reported fewer child behaviour problems (Dw=-0.43, 95%CI [-0.77,-0.08]) and greater household wealth (Dw=0.57, 95%CI [0.08,1.06]). However, children in agribusiness-only villages reported increased physical abuse (IRR=2.26, 95%CI [1.00,5.12]) and less positive parenting (Dw=-0.50, 95%CI [-0.91,-0.10]). There were no other adverse effects. Conclusion: Parent training may be the active ingredient in reducing maltreatment in farmer groups with majority male caregivers, while agribusiness training programmes may have unintended negative consequences on children when delivered alone. Locating parenting support in existing farmer groups can engage a much higher proportions of fathers than stand-alone programmes

Towards a coordinated strategy for intercepting human disease emergence in Africa

Non peer reviewe

Improved salt iodation methods for small-scale salt producers in low-resource settings in Tanzania

Background: Universal salt iodation will prevent iodine deficiency disorders (IDD). Globally, salt-iodation technologies mostly target large and medium-scale salt-producers. Since most producers in low-income countries are small-scale, we examined and improved the performance of hand and knapsack-sprayers used locally in Tanzania. Methods: We studied three salt facilities on the Bagamoyo coast, investigating procedures for preparing potassium-iodate solution, salt spraying and mixing. Different concentrations of solution were prepared and tested using different iodation methods, with the aim of attaining correct and homogeneous iodine levels under real-life conditions. Levels achieved by manual mixing were compared to those achieved by machine mixing. Results: The overall median iodation level in samples of salt iodated using previously existing methods was 10.6 ppm (range 1.1 – 110.0 ppm), with much higher levels in the top than the bottom layers of the salt bags, p < 0.0001. Experimentation using knapsack-sprayers and manual mixing led to the reliable achievement of levels (60.9 ppm ± 7.4) that fell within the recommended range of 40 – 80 ppm. The improved methods yielded homogenous iodine concentrations in all layers of salt-bags (p = 0.58) with 96% of the samples (n = 45) falling within 40 – 80 ppm compared to only 9% (n = 45) before the experiment and training (p < 0.0001). For knapsack-spraying, a machine mixer improved the iodine levels and homogeneity slightly compared to manual mixing (p = 0.05). Conclusion: Supervised, standardized salt iodation procedures adapted to local circumstances can yield homogeneous iodine levels within the required range, overcoming a major obstacle to universal salt iodation

Assets and domestic units: methodological challenges for longitudinal studies of poverty dynamics

Tracking change in assets access and ownership in longitudinal research is difficult. Assets are rarely assigned to individuals. Their benefit and management are spread across domestic units which morph over time. We review the challenges of using assets to understand poverty dynamics, and tracking the domestic units that own and manage assets. Using case studies from longitudinal research we demonstrate that assets can afford useful insights into important change

Low sensitivity of a urine LAM-ELISA in the diagnosis of pulmonary tuberculosis

<p>Abstract</p> <p>Background</p> <p>The development and evaluation of rapid and accurate new diagnostic tools is essential to improve tuberculosis (TB) control in developing countries. In a previous study, the first release of a urine LAM-ELISA by Chemogen (Portland, USA) has been evaluated with a promising sensitivity and specificity for the diagnosis of pulmonary TB. In the present study, the now commercially available assay has been clinically assessed regarding its diagnostic value alone and in combination with clinical co-factors.</p> <p>Methods</p> <p>The test was applied to two urine samples from 291 consecutively enrolled Tanzanian patients with suspected pulmonary tuberculosis. The participants were subsequently assigned to classification groups according to microbiological, clinical and radiological findings at recruitment and during a maximum follow up period of 56 days.</p> <p>Results</p> <p>Only 35 out of 69 pulmonary TB cases -confirmed by smear microscopy and/or solid culture and/or liquid culture- showed at least one positive LAM-ELISA result (sensitivity 50.7%). The sensitivity was noticeably higher in females (66.7%) and in HIV positive participants (62.0%). The specificity amounted to 87.8% and was determined in participants with negative results in all microbiological tests and with sustained recovery under antibiotic treatment at day 56. Correlation with urinalysis revealed that proteinuria was significantly and positively associated with LAM-positivity (<it>P </it>= 0.026).</p> <p>Conclusion</p> <p>This commercially available generation of LAM-ELISA does not appear to be useful as an independent diagnostic test for pulmonary tuberculosis. The question whether the assay is suitable as a supplemental device in the diagnosis of HIV-associated TB, requires further investigations.</p

Nomenclature- and Database-Compatible Names for the Two Ebola Virus Variants that Emerged in Guinea and the Democratic Republic of the Congo in 2014

In 2014, Ebola virus (EBOV) was identified as the etiological agent of a large and still expanding outbreak of Ebola virus disease (EVD) in West Africa and a much more confined EVD outbreak in Middle Africa. Epidemiological and evolutionary analyses confirmed that all cases of both outbreaks are connected to a single introduction each of EBOV into human populations and that both outbreaks are not directly connected. Coding-complete genomic sequence analyses of isolates revealed that the two outbreaks were caused by two novel EBOV variants, and initial clinical observations suggest that neither of them should be considered strains. Here we present consensus decisions on naming for both variants (West Africa: “Makona”, Middle Africa: “Lomela”) and provide database-compatible full, shortened, and abbreviated names that are in line with recently established filovirus sub-species nomenclatures

Examining oral pre-exposure prophylaxis (PrEP) literacy among participants in an HIV vaccine trial preparedness cohort study

Background: PrEP literacy is influenced by many factors including the types of information available and how it is interpreted. The level of PrEP literacy may influence acceptability and uptake. Methods: We conducted 25 in-depth interviews in a HIV vaccine trial preparedness cohort study. We explored what participants knew about PrEP, sources of PrEP knowledge and how much they know about PrEP. We used the framework approach to generate themes for analysis guided by the Social Ecological Model and examined levels of PrEP literacy using the individual and interpersonal constructs of the SEM. Results: We found that PrEP awareness is strongly influenced by external factors such as social media and how much participants know about HIV treatment and prevention in the local community. However, while participants highlighted the importance of the internet/social media as a source of information about PrEP they talked of low PrEP literacy in their communities. Participants indicated that their own knowledge came as a result of joining the HIV vaccine trial preparedness study. However, some expressed doubts about the effectiveness of the drug and worried about side effects. Participants commented that at the community level PrEP was associated with being sexually active, because it was used to prevent the sexual transmission of HIV. As a result, some participants commented that one could feel judged by the health workers for asking for PrEP at health facilities in the community. Conclusion: The information collected in this study provided an understanding of the different layers of influence around individuals that are important to address to improve PrEP acceptability and uptake. Our findings can inform strategies to address the barriers to PrEP uptake, particularly at structural and community levels. Trial registration: https://clinicaltrials.gov/ct2/show/NCT04066881