Biology of the African lungfish Protopterus aethiopicus Heckel 1851, and some aspects of its fishery in Lake Baringo, Kenya

The introduction of the marbled lungfish (Protopterus aethiopicus) into Lake Baringo created a new fishery. This study describes the life history characteristics and movements of this population, and provides baseline biological information for more rational exploitation and management of its fishery. Biological data were obtained from fishery landings, while movement and space use were studied using ultrasonic telemetry. -- Biological data indicate Lake Baringo lungfish grow allometrically, individual growth in length was about 14.5 cm year ⁻¹. Males mature later than females, but are less abundant in open waters, likely because they spend more time in inshore spawning areas. Spawning occurs year-round, probably related to the lack of a predictable rainy season in Lake Baringo. Internal differentiation of the digestive tract was apparent contrary to previous reports. Their diet in Lake Baringo is primarily piscivorous. -- Ultrasonic telemetry showed lungfish are not sluggish, but rather make nonrandom daily movements (likely in search of prey) in the open waters and were active at night as well as in the day. Their movements consisted of: 1) shorter daily movements over several weeks or months, followed by 2) a series of successive longer daily movements over a few days, and there was evidence of navigational ability. Sonically tagged lungfish ranged widely but tended to avoid shallow inshore waters where crocodiles are abundant. However, some had home ranges of varying size (5.8 - 19.8 km²) and which were occupied for 2 - 4.5 months. Ultrasonic-tagged fish were always relocated in the lake, however, one radio-tagged lungfish was caught in a swamp upstream on the Molo River about 4.5 months after release, indicating lungfish can and do migrate out of the lake. -- Radio telemetry results suggested that P. aethiopicus are not obligate air breathers. Aerial respiration is necessary, however, during stress situations and this probably explains the death of most lungfish caught on long-lines. Attaching hooks to long leaders will allow hooked fish to access the surface and increase live lungfish landings, which earn more income. Maintenance of a viable lungfish fishery in Lake Baringo depends on protection and conservation of shallow inshore riparian areas and control of illegal fishing practices

Systems thinking in practice: the current status of the six WHO building blocks for health system strengthening in three BHOMA intervention districts of Zambia: a baseline qualitative study.

BACKGROUND: The primary bottleneck to achieving the MDGs in low-income countries is health systems that are too fragile to deliver the volume and quality of services to those in need. Strong and effective health systems are increasingly considered a prerequisite to reducing the disease burden and to achieving the health MDGs. Zambia is one of the countries that are lagging behind in achieving millennium development targets. Several barriers have been identified as hindering the progress towards health related millennium development goals. Designing an intervention that addresses these barriers was crucial and so the Better Health Outcomes through Mentorship (BHOMA) project was designed to address the challenges in the Zambia's MOH using a system wide approach. We applied systems thinking approach to describe the baseline status of the Six WHO building blocks for health system strengthening. METHODS: A qualitative study was conducted looking at the status of the Six WHO building blocks for health systems strengthening in three BHOMA districts. We conducted Focus group discussions with community members and In-depth Interviews with key informants. Data was analyzed using Nvivo version 9. RESULTS: The study showed that building block specific weaknesses had cross cutting effect in other health system building blocks which is an essential element of systems thinking. Challenges noted in service delivery were linked to human resources, medical supplies, information flow, governance and finance building blocks either directly or indirectly. Several barriers were identified as hindering access to health services by the local communities. These included supply side barriers: Shortage of qualified health workers, bad staff attitude, poor relationships between community and health staff, long waiting time, confidentiality and the gender of health workers. Demand side barriers: Long distance to health facility, cost of transport and cultural practices. Participating communities seemed to lack the capacity to hold health workers accountable for the drugs and services. CONCLUSION: The study has shown that building block specific weaknesses had cross cutting effect in other health system building blocks. These linkages emphasised the need to use system wide approaches in assessing the performance of health system strengthening interventions

Assessing risk of HIV and hepatitis C among people who inject drugs in East Africa: findings from a rapid assessment

Rapid assessment cross-sectional surveys and qualitative interviews were conducted among people who inject drugs (PWID) in Burundi and Uganda, as well as key informants working with drug users, to assess risk associated with HIV and hepatitis C (HCV). A total of 127 PWID were recruited in Burundi and 125 in Uganda of which the majority were male and aged between 24 and 26 years. Blood samples were collected in Burundi to test for antibodies to HIV, HCV and B Surface Antigen (HBsAg). Heroin was mainly injected in Uganda and Burundi with a small minority injecting crack/cocaine. Half of participants in Burundi, and 86% in Uganda had been HIV tested. The minority had been tested for HCV in any site (5-7%). HIV prevalence from the serological testing in Burundi indicated that 10% tested positive for antibodies to HIV, 6% to HCV and 9% to HBsAg. Qualitative data suggested that structural factors including costs of needle/syringes as well policies prohibiting pharmacies selling injecting equipment to PWID were related to reuse and sharing of needles/syringes among PWID, despite awareness HIV transmission risk. Police arrest was common in Burundi and Uganda and the use of bribes by police compounded existing high levels of poverty. Findings accentuate the need for policy shifts to enable easier access to clean injecting equipment, increased availability of HIV and HCV testing and increased access to affordable drug treatment and introduction of opioid substitution therapy. Specific attention is needed to the potential for sexual transmission of HIV among this population

Barriers and facilitators of access to HIV, harm reduction and sexual and reproductive health services by women who inject drugs:role of community-based outreach and drop-in centers

There is limited data regarding women who inject drugs, and how harm-reduction services can be made more women-centered. This study explored experiences of Kenyan women who inject drugs, with regard to access to HIV, harm reduction and sexual and reproductive health (SRH) services. A total of 45 women who inject drugs and 5 key stakeholders participated in-depth interviews and focus group discussions. Thematic analysis of the data revealed that stigma, long distances, lack of confidentiality, user fees, multiple appointments, drug users’ unfamiliarity with health facilities, disconnect in communication with healthcare providers, and healthcare providers’ lack of understanding of women’s needs were factors that impede women’s access to health services. Community-based services, comprising of outreach and drop-in centers mitigate these barriers by building trust, educating women on their health and rights, linking women to health facilities, sensitizing health providers on the needs of women who inject drugs, and integrating women’s SRH services into community-based harm-reduction outreach. Inclusion of SRH services into community-based harm-reduction activities increased women’s interest and access to harm-reduction interventions. These findings underscore the need to strengthen community-based programming for women who inject drugs, and to integrate SRH services into needle and syringe exchange programs

Contraceptive Use among Women who Inject Drugs:Motivators Barriers and Unmet Needs

We explored contraceptive use among 45 women who inject drugs in coastal Kenya. Overall, 29% were using contraceptives, motivated by a fear of unplanned pregnancy, a desire to shield children from the difficulties of drug use, the need to prevent HIV and other sexually transmitted infections, encouragement from health providers and outreach workers, or because they had achieved the desired number of children. However, 69% were not using contraceptives. Barriers to use included current pregnancy intentions, perceived infertility due to drug-induced amenorrhea, side effects, intimate partners’ influence, lack of information, complex health care appointments, and transportation costs. Rights-based integration of sexual and reproductive health into harm reduction services for women who inject drugs is required to minimize unmet contraception needs

HIV Drug Resistance (HIVDR) in Antiretroviral Therapy-Naïve Patients in Tanzania Not Eligible for WHO Threshold HIVDR Survey Is Dramatically High

The World Health Organization (WHO) has recommended guidelines for a HIV drug resistance (HIVDR) survey for resource-limited countries. Eligibility criteria for patients include age below 25 years in order to focus on the prevalence of transmitted HIVDR (tHIVDR) in newly-infected individuals. Most of the participating sites across Africa have so far reported tHIVDR prevalences of below 5%. In this study we investigated whether the rate of HIVDR in patients <25 years is representative for HIVDR in the rest of the therapy-naïve population. HIVDR was determined in 88 sequentially enrolled ART-naïve patients from Mwanza, Tanzania (mean age 35.4 years). Twenty patients were aged <25 years and 68 patients were aged 25-63 years. The frequency of HIVDR in the study population was 14.8% (95%; CI 0.072-0.223) and independent of NVP-resistance induced by prevention of mother-to-child transmission programs. Patients >25 years had a significantly higher HIVDR frequency than younger patients (19.1%; 95% CI 0.095-0.28) versus 0%, P = 0.0344). In 2 out of the 16 patients with HIVDR we found traces of antiretrovirals (ARVs) in plasma. ART-naïve patients aged over 25 years exhibited significantly higher HIVDR than younger patients. Detection of traces of ARVs in individuals with HIVDR suggests that besides transmission, undisclosed misuse of ARVs may constitute a significant factor in the generation of the observed high HIVDR rate. The current WHO tHIVDR survey that is solely focused on the transmission of HIVDR and that excludes patients over 25 years of age may therefore result in substantial underestimation of the prevalence of HIVDR in the therapy-naïve population. Similar studies should be performed also in other areas to test whether the so far reported optimistic picture of low HIVDR prevalence in young individuals is really representative for the rest of the ART-naïve HIV-infected population

A comparative study of the growth and feeding of underyearling (0+) Brown Trout (Salmo trutta Linn.) in disturbed and undisturbed stream habitats in the Avalon Peninsula, Newfoundland

Although natural freshwater bodies on insular Newfoundland are oligotrophic, high growth and biomass of salmonids has been reported in streams within the city of St. John's. This study compared the growth and feeding of underyearling (0+) brown trout (Salmo trutta Linn.) from Juniper Brook, a headwater tributary of the Rennies River, which flows through the city; and a tributary of the Broad Cove River, outside the metropolitan area. Zero plus trout were obtained by electrofishing once every three weeks during the summer and fall of 1994 and 1995, with one sample collected in the intervening winter. In both years, fry in Juniper brook emerged later from the redds but grew at a faster rate and attained a slightly bigger size by the end of the growing season. Arithmetic growth curves for trout in each stream approximated the characteristic sigmoid curve. Within streams, growth rates were highest in early summer. Stream water temperatures showed consistent differences, with Juniper Brook warming up faster in the summer and cooling faster in the fall. -- The composition of 0+ trout diet varied between streams and seasons and was related to changes in the food available both in the streams and adjacent terrestrial vegetation. Benthic samples from Juniper Brook had fewer taxa and were dominated by chironomid larvae, whereas those from Broad Cove River had a higher taxonomic diversity but fewer numbers per taxon. Chironomids were consumed almost exclusively by 0+ trout in Juniper Brook during the summer but those in Broad Cove River had a much broader diet. Stomach contents were at times dominated by a single prey, suggesting opportunistic feeding, probably on the most abundant and available prey in the feeding environment. The higher abundance of chironomids in Juniper Brook was related to higher chemical richness resulting from the input of liquid and solid urban wastes. Thus the human disturbance that has occurred on Juniper Brook has altered the ecology of the stream resulting in higher stream temperatures in the summer and higher chemical richness which promoted the growth of 0+ trout in this stream

Acceptability of medical male circumcision among uncircumcised young men at Mansa College of Education, Zambia : influence of perceptions about effects on male sexuality

Thesis (MPhil)--Stellenbosch University, 2013.ENGLISH ABSTRACT: Research focus: Voluntary Medical Male Circumcision (VMMC) is one of the top priority interventions for HIV prevention in Zambia. However, the country is struggling with scale-up of this intervention. New insights into factors that facilitate or impede its acceptability in non-circumcising communities are urgently needed, including the influence of perceptions about effects of circumcision on sexuality. Research methods: To gain new insights into these factors 24 uncircumcised young men and seven young women were recruited to participate in the study. Using ten In-depth interviews and three focus group discussions, the study examined perceptions about effects of MMC on male sexuality and the influence on acceptability of the procedure. Results/findings: Despite doubts about its efficacy, the research found overwhelming support among uncircumcised men for circumcision as a tool for preventing HIV. The study also found that uncircumcised men have specific perceptions and concerns about how male circumcision positively or negatively affects sexual function/performance and pleasure in men and for women. These perceptions were found to be important considerations for accepting circumcision among the majority of male respondents. Circumcision preference among female respondents was because of the perception that it protects men against HIV and women against cervical cancer. Main conclusions and recommendations: There was overwhelming support for male circumcision among uncircumcised men in the study, majority of who consider protection against HIV as the most important reason for accepting the procedure. More than half of the male respondents saw it as important for enhancing sexual performance and sexual pleasure for themselves and their sexual partners. Key recommendations include: development of effective community-based demand generation strategies that include use of multiple channels that address the main barriers to acceptability; conduct further research on facilitators of MMC acceptability; conduct research on effects of circumcision on male sexuality, risk compensation and sexual disinhibit ion among circumcised men. These measures will contribute to the design of more effective Information Education Communication (IEC) strategies and activities.AFRIKAANSE OPSOMMING: Navorsingsfokus: Vrywillige mediese manlike besnydenis (VMMB) is een van die hoofprioriteitsintervensies vir MIV-voorkoming in Zambië. Tog sukkel die land om hierdie intervensie uit te brei. Daar is dus ’n dringende behoefte aan nuwe insig in die faktore wat bepaal hoe maklik of moeilik gemeenskappe wat nié aan besnydenis glo nie, die intervensie sal aanvaar. Dít sluit in die invloed van opvattings oor die effek van besnydenis op seksualiteit. Navorsingsmetode: Om nuwe insig in hierdie faktore te verkry, is 24 onbesnyde jong mans en sewe jong vroue gewerf om aan die studie deel te neem. Met behulp van tien diepteonderhoude en drie fokusgroepbesprekings het die studie ondersoek ingestel na die opvattings oor die effek van MMB op manlike seksualiteit, en in watter mate dit die aanvaarbaarheid van die prosedure beïnvloed. Resultate/bevindinge: Ondanks twyfel oor die doeltreffendheid van die prosedure, dui die navorsing daarop dat onbesnyde mans oorweldigend ten gunste is van besnydenis as instrument om MIV te voorkom. Die studie bevind ook dat onbesnyde mans bepaalde opvattings het oor die hetsy positiewe of negatiewe uitwerkings van manlike besnydenis op seksuele funksionering/prestasie en genot vir mans sowel as vroue. Vir die meeste manlike respondente blyk hierdie opvattings belangrike oorwegings te wees in die aanvaarding van besnydenis. Vrouerespondente se voorkeur vir besnydenis kan toegeskryf word aan die opvatting dat dit mans teen MIV en vroue teen servikskanker beskerm. Hoofgevolgtrekkings en -aanbevelings: Die onbesnyde mans in die studie is oorweldigend ten gunste van manlike besnydenis. Die meeste van hulle beskou beskerming teen MIV as die belangrikste rede om die prosedure te aanvaar. Meer as die helfte van die manlike respondente reken ook besnydenis is belangrik om seksuele prestasie en genot vir hulself sowel as hul bedmaats te verhoog. Hoofaanbevelings sluit in die ontwikkeling van doeltreffende gemeenskapsgebaseerde vraagverhogingstrategieë, wat onder meer van verskeie kanale gebruik maak om die hoofversperrings vir aanvaarbaarheid uit die weg te ruim; verdere navorsing oor faktore wat MMB-aanvaarbaarheid fasiliteer, sowel as navorsing oor die effek van besnydenis op manlike seksualiteit, risiko-kompensasie en seksuele disinhibisie onder besnyde mans. Inligting hieroor sal bydra tot die ontwerp van doeltreffender inligting-en-opvoedingstrategieë en -aktiwiteite