Malaria Rapid Testing by Community Health Workers Is Effective and Safe for Targeting Malaria Treatment: Randomised Cross-Over Trial in Tanzania

Early diagnosis and prompt, effective treatment of uncomplicated malaria is critical to prevent severe disease, death and malaria transmission. We assessed the impact of rapid malaria diagnostic tests (RDTs) by community health workers (CHWs) on provision of artemisinin-based combination therapy (ACT) and health outcome in fever patients. Twenty-two CHWs from five villages in Kibaha District, a high-malaria transmission area in Coast Region, Tanzania, were trained to manage uncomplicated malaria using RDT aided diagnosis or clinical diagnosis (CD) only. Each CHW was randomly assigned to use either RDT or CD the first week and thereafter alternating weekly. Primary outcome was provision of ACT and main secondary outcomes were referral rates and health status by days 3 and 7. The CHWs enrolled 2930 fever patients during five months of whom 1988 (67.8%) presented within 24 hours of fever onset. ACT was provided to 775 of 1457 (53.2%) patients during RDT weeks and to 1422 of 1473 (96.5%) patients during CD weeks (Odds Ratio (OR) 0.039, 95% CI 0.029-0.053). The CHWs adhered to the RDT results in 1411 of 1457 (96.8%, 95% CI 95.8-97.6) patients. More patients were referred on inclusion day during RDT weeks (10.0%) compared to CD weeks (1.6%). Referral during days 1-7 and perceived non-recovery on days 3 and 7 were also more common after RDT aided diagnosis. However, no fatal or severe malaria occurred among 682 patients in the RDT group who were not treated with ACT, supporting the safety of withholding ACT to RDT negative patients. RDTs in the hands of CHWs may safely improve early and well-targeted ACT treatment in malaria patients at community level in Africa.\ud \ud \ud \u

Distribution and ecological risks of toxic metals in the topsoils in the Kumasi metropolis, Ghana

The distribution, and ecological risks due to toxic metals in topsoils of an urban commercial centre of Kumasi metropolis were determined. Concentrations of heavy metals in the samples were initially screened using field portable X-ray fluorescence spectrometer prior to confirmation on an inductively coupled plasma-mass spectrometer. The results from the two instruments correlated well with high linearity (R2 > 0.70). Concentrations of metals were in the order: Fe (45246.15 mg/kg) > Mn (347.86 mg/kg) > Zn (176.40 mg/kg) > V (173.10 mg/kg) > Cr (125.12 mg/kg) > Pb (53.47 mg/kg) > Ni (43.16 mg/kg) > Cu (39.85 mg/kg) > As (4.59 mg/kg) > Sn (3.69 mg/kg) > Cd (0.46 mg/kg) > Hg (0.28 mg/kg). Multivariate and geostatistical analyses exploring various hazard indices such as geo-accumulation, contamination, pollution load and ecological risks all suggest contamination of the topsoils with toxic metals and that the contamination due to Pb, Cu, Ni, Cr and Zn is mainly derived from anthropogenic origins whereas, As, Hg, Mn, V, Sn and Cd contaminations are attributable mainly to geological and atmospheric depositions. Contamination factor (CF) suggests that the topsoils were considerably contaminated (CF 3–6) with Zn, moderately contaminated (CF 1–3) with Ni, Hg, V, Sn and Cd and least contaminated (CF < 1) with As, Pb, Cu, Cr and Mn. In general, the soils were found to be moderately contaminated (average contamination factor (1 ≤ CF < 3) with toxic metals and may pose both human and ecological risks

Environment of severe storm formations over West Africa on the 26‐28 June 2018

Abstract Understanding the environmental evolution of mesoscale convective systems (MCSs) is critical for forecasting weather in West Africa. This study investigated the thermodynamic and synoptic environments of MCSs over West Africa on 26 (storm 1) and 28 (storm 2) June 2018. Primary datasets used to assess the diurnal evolution of the storms were obtained from ERA5. The results showed a trapped gravity wave, enhanced by a well‐established African Easterly Jet and monsoon trough, was responsible for the initiation of storm 1. Both storms also initiated in the presence of several moist lower (925–850 hPa) to mid‐tropospheric (600 hPa) cyclonic and anticyclonic vortices, controlling inland moisture advection. The lower troposphere was moistened through moisture advection by the West African westerly jet for storm 1 and the nocturnal low‐level jet prior to initiation for storm 2. For both storms, the evolution of outgoing longwave radiation showed a consistent atmosphere of deep afternoon convection. Boundary layer height increased significantly during storm evolution to support the increasing ascent of warm air. Vegetation cover differences may have also likely aided the evolution of storm 2. The passage of gravity waves from decaying storms can aid forecasters to nowcast likely regions of afternoon convection with high accuracy. Under the GCRF African Science for Weather Information and Forecasting Techniques (SWIFT), these findings are crucial in fulfilling the project's aims of improving weather forecasting capability and communication over West Africa

Tropical Africa’s first testbed for high-impact weather forecasting and nowcasting

Testbeds have become integral to advancing the transfer of knowledge and capabilities from research to operational weather forecasting in many parts of the world. The first high-impact weather testbed in tropical Africa was recently carried out through the African SWIFT program, with participation from researchers and forecasters from Senegal, Ghana, Nigeria, Kenya, the United Kingdom, and international and pan-African organizations. The testbed aims were to trial new forecasting and nowcasting products with operational forecasters, to inform future research, and to act as a template for future testbeds in the tropics. The African SWIFT testbed integrated users and researchers throughout the process to facilitate development of impact-based forecasting methods and new research ideas driven both by operations and user input. The new products are primarily satellite-based nowcasting systems and ensemble forecasts at global and regional convection-permitting scales. Neither of these was used operationally in the participating African countries prior to the testbed. The testbed received constructive, positive feedback via intense user interaction including fishery, agriculture, aviation, and electricity sectors. After the testbed, a final set of recommended standard operating procedures for satellite-based nowcasting in tropical Africa have been produced. The testbed brought the attention of funding agencies and organizational directors to the immediate benefit of improved forecasts. Delivering the testbed strengthened the partnership between each country’s participating university and weather forecasting agency and internationally, which is key to ensuring the longevity of the testbed outcomes