Can Conservation Agriculture Technologies Mitigate Intra-Seasonal Drought Effects on Crop Yields in Steep Lands? Case of the Southern Uluguru Mountains, Tanzania

This study was conducted in the 2015 and 2015/16 rain seasons at Kolero village, in the southern Uluguru Mountains, Tanzania. The aim was to investigate the effectiveness of different Conservation Agriculture (CA) practices on runoff control and soil moisture retention as well as its implication on rainfall use efficiency (RUE) and crop production and environmental conservation on the steep slopes. Two factors (tillage practice and soil surface cover mulches, i.e. crop residues and cover crops) each at three levels, were combined to form a 3 x 3 factorial experiment and tested in a Randomized Complete Block Design (RCBD) with three replications each. Levels of tillage were shallow tillage, zero tillage and strip tillage; and those for cover crop were slash and burn, lablab and cowpea cover crops with residue retention. Moisture readings were taken at 0 - 20 cm, 20 - 40 cm, 40 – 60 cm, 60 – 80 cm and 80 - 100 cm soil depths. Results showed that there were significant differences (P<0.05) among treatments in runoff, at which conventional tillage recorded 26.7% and 42.2% runoff for 2015 and 2015/16 rain seasons respectively, while CA treatments had between 3.5 to 22.2 % runoff. There was also numerically higher volumetric moisture content for most of the cropping months in CA treatments at 0 to 45 cm soil depths. Soil temperature was high in conventional practices from 0 to 100 cm soil depths as compared to CA treatment for most of the cropping months. Conventional practice also showed significant difference (P<0.05) as it recorded the lowest RUE (4.2 kg ha-1 mm-1) compared to CA treatments whose RUE ranged between 5.8 and 6.3 kg ha-1 mm-1 for the 2015/16 rain season which had erratic rainfall and prolonged dry spells. Most CA treatments were observed to be more effective in runoff control, moisture conservation as well as provision of high RUE at fragile foothills of southern Uluguru Mountains. CA treatments have shown to be effective in mitigating intra-season dry spells. Keywords: conservation agriculture, runoff, soil moisture, soil temperature, slash and bur

Microbiological studies of cockroaches from three localities in Gaborone, Botswana

Cockroaches have become the most common pests in a majority of households in Gaborone, the capital city of Botswana Their presence has always raised safety concerns, especially as carriers of food-borne pathogens and food-spoilage organisms. To address the safety issues, bacteriological investigations were carried out on cockroaches trapped from the kitchens and toilets of three localities in Gaborone, households in Botswana. The bacterial, total spore forming, Bacillus cereus, coliforms and E. coli counts from the surfaces of cockroaches were estimated using bacteriological media. Aerobic and facultatively anaerobic bacteria from the fecal pellets were isolated and characterized. Specialized mediawere used for culturing pathogens. 67 %, 22.2 % and 28.6 % of the cockroaches trapped in the kitchen from Central/Broadhurst, Old Naledi and Tlokweng, respectively, had aerobic plate counts of > 106 CFU/cockroach. The cockroaches trapped from the toilets had higher counts than kitchens. Sporeformers were present in most samples though in lower numbers. However, Bacillus cereus was only found in some of the cockroaches at much lower numbers. As much as 70– 98.3% of the cockroaches had coliforms; but, E. coli was only found in 5–6.5% of the cockroaches at > 103 CFU/cockroach. 70 species of bacteria representing 37 genera were isolated from the surface and fecal pellets. Even though the majority of the bacteria that were isolated from the surfaces were Gram negative thosefrom the pellets were mostly Gram positive. The most common and abundant species belonged to Pseudomonas and Serratia, with members of the Enterobacteriaceae following. In the pellets, species of Bacillus were predominant, but, there were some members of Enterobacteriaceae. Pathogens like Salmonella, Shigella and B. cereus were isolated. Opportunistic pathogens like species of Pseudomonas, Klebsiella and Vibrio and food spoilage bacteria such as species of Enterobacter, Citrobacter, Escherichia, Erwinia, and Pseudomonas were also found. Proper care in disposal of food remnants and overall cleanliness at the householdsprevents cockroaches from foraging in the kitchen and toilet

Diagnostic value of pneumoperitoneum on plain abdominal film in patients with suspected visceral perforation at Bugando Medical Centre, Mwanza, Tanzania

Background:  The presence of pneumoperitoneum on plain abdominal film has been widely used in many centres in Tanzania as primary diagnostic imaging in patients with suspected visceral perforation. However, its diagnostic value has not yet been assessed in any hospital in the country including Bugando Medical Centre (BMC), and therefore its use as a diagnostic tool in these patients is not justified. This existing knowledge gap prompted the author to conduct this study. The study aimed to determine the diagnostic value of pneumoperitoneum on plain abdominal film in patients with suspected visceral perforation in our local setting. Methods: This was a prospective cross-sectional study among patients with suspected visceral perforation at BMC from June 2017 to May 2018. Pneumoperitoneum on plain abdominal radiography was evaluated, and the findings were cross-tabulated against operative findings, the gold standard. Then, the sensitivity, specificity, accuracy, Positive Predictive Value, Negative Predictive Value and accuracy were calculated to determine the diagnostic value of pneumoperitoneum on plain abdominal film. The Kappa statistic (қ) was calculated to determine the degree of agreement with operative findings. Results: A total of 132 patients were studied. The median age of patients was 35 years. The diagnostic accuracy of pneumoperitoneum on plain abdominal film in the detection of perforation was 90.9% with sensitivity, specificity, PPV and NPV of 90.1%, 92.7%, 96.5% and 80.9% respectively. There was good agreement with operative findings (κ = 0.86). The perforations of the ileum, gastric, duodenum, colon and appendix accounted for 36.3%, 22.0%, 19.8%, 11.0% and 11.0% of cases, respectively. The sensitivity, specificity, PPV, NPV and accuracy perforations of the ileum, gastric, duodenum, colon and appendix were 61.5-100%, 31.7-46.5%, 10.6-37.7%, 85.1-100% and 38.6-59.1% respectively.  The kappa statistics showed good agreement with the operative findings (ķ = 0.76-0.89). Conclusion: The presence of pneumoperitoneum on plain abdominal film provides high diagnostic value in the detection of visceral perforation and can be employed at BMC to improve the diagnostic value in patients with suspected visceral perforation and subsequently reduce negative laparotomy and complication rates

Levels and Correlates of Non-Adherence to WHO Recommended Inter-Birth Intervals in Rufiji, Tanzania.

Poorly spaced pregnancies have been documented worldwide to result in adverse maternal and child health outcomes. The World Health Organization (WHO) recommends a minimum inter-birth interval of 33 months between two consecutive live births in order to reduce the risk of adverse maternal and child health outcomes. However, birth spacing practices in many developing countries, including Tanzania, remain scantly addressed. METHODS: Longitudinal data collected in the Rufiji Health and Demographic Surveillance System (HDSS) from January 1999 to December 2010 were analyzed to investigate birth spacing practices among women of childbearing age. The outcome variable, non-adherence to the minimum inter-birth interval, constituted all inter-birth intervals <33 months long. Inter-birth intervals >=33 months long were considered to be adherent to the recommendation. Chi-Square was used as a test of association between non-adherence and each of the explanatory variables. Factors affecting non-adherence were identified using a multilevel logistic model. Data analysis was conducted using STATA (11) statistical software. RESULTS: A total of 15,373 inter-birth intervals were recorded from 8,980 women aged 15--49 years in Rufiji district over the follow-up period of 11 years. The median inter-birth interval was 33.4 months. Of the 15,373 inter-birth intervals, 48.4% were below the WHO recommended minimum length of 33 months between two live births. Non-adherence was associated with younger maternal age, low maternal education, multiple births of the preceding pregnancy, non-health facility delivery of the preceding birth, being an in-migrant resident, multi-parity and being married. CONCLUSION: Generally, one in every two inter-birth intervals among 15--49 year-old women in Rufiji district is poorly spaced, with significant variations by socio-demographic and behavioral characteristics of mothers and newborns. Maternal, newborn and child health services should be improved with a special emphasis on community- and health facility-based optimum birth spacing education in order to enhance health outcomes of mothers and their babies, especially in rural settings

Rifapentine and isoniazid for prevention of tuberculosis in people with diabetes (PROTID): protocol for a randomised controlled trial.

BACKGROUND: Diabetes mellitus (DM) increases the risk of tuberculosis (TB) and will hamper global TB control due to the dramatic rise in type 2 DM in TB-endemic settings. In this trial, we will examine the efficacy and safety of TB preventive therapy against the development of TB disease in people with DM who have latent TB infection (LTBI), with a 12-week course of rifapentine and isoniazid (3HP). METHODS: The 'Prevention of tuberculosis in diabetes mellitus' (PROTID) consortium will randomise 3000 HIV-negative eligible adults with DM and LTBI, as evidenced by a positive tuberculin skin test or interferon gamma release assay, to 12 weeks of 3HP or placebo. Participants will be recruited through screening adult patients attending DM clinics at referral hospitals in Tanzania and Uganda. Patients with previous TB disease or treatment with a rifamycin medication or isoniazid (INH) in the previous 2 years will be excluded. The primary outcome is the occurrence of definite or probable TB disease; secondary outcome measures include adverse events, all-cause mortality and treatment completion. The primary efficacy analysis will be intention-to-treat; per-protocol analyses will also be carried out. We will estimate the ratio of TB incidence rates in intervention and control groups, adjusting for the study site using Poisson regression. Results will be reported as efficacy estimates (1-rate ratio). Cumulative incidence rates allowing for death as a competing risk will also be reported. Approximately 1000 LTBI-negative, HIV-negative participants will be enrolled consecutively into a parallel cohort study to compare the incidence of TB in people with DM who are LTBI negative vs positive. A number of sub-studies will be conducted among others to examine the prevalence of LTBI and active TB, estimate the population impact and cost-effectiveness of LTBI treatment in people living with DM in these African countries and address gaps in the prevention and therapeutic management of combined TB-DM. DISCUSSION: PROTID is anticipated to generate key evidence to guide decisions over the use of TB preventive treatment among people with DM as an important target group for better global TB control. TRIAL REGISTRATION: ClinicalTrials.gov NCT04600167 . Registered on 23 October 2020

Indicators of optimal diabetes care and burden of diabetes complications in Africa: a systematic review and meta-analysis.

OBJECTIVE: Contemporary data on the attainment of optimal diabetes treatment goals and the burden of diabetes complications in adult populations with type 2 diabetes in Africa are lacking. We aimed to document the current status of attainment of three key indicators of optimal diabetes care and the prevalence of five diabetes complications in adult African populations with type 2 diabetes. METHODS: We systematically searched Embase, PubMed and the Cochrane library for published studies from January 2000 to December 2020. Included studies reported any information on the proportion of attainment of optimal glycated haemoglobin (HbA1c), blood pressure (BP) and low-density lipoprotein cholesterol (LDLC) goals and/or prevalence of five diabetes complications (diabetic peripheral neuropathy, retinopathy, nephropathy, foot ulcers and peripheral arterial disease). Random effect model meta-analysis was performed to determine the pooled proportion of attainment of the three treatment goals and the prevalence of five diabetes complications. RESULTS: In total, 109 studies with a total of 63 890 participants (53.3% being females) were included in the meta-analysis. Most of the studies were conducted in Eastern African countries (n=44, 40.4%). The pooled proportion of attainment of an optimal HbA1c, BP and LDLC goal was 27% (95% CI 24 to 30, I2=94.7%), 38% (95% CI 30 to 46, I2=98.7%) and 42% (95% CI 32 to 52, I2=97.4%), respectively. The pooled prevalence of diabetic peripheral neuropathy, retinopathy, diabetic nephropathy, peripheral arterial disease and foot ulcers was 38% (95% CI 31 to 45, I2=98.2%), 32% (95% CI 28 to 36, I2=98%), 31% (95% CI 22 to 41, I2=99.3%), 19% (95% CI 12 to 25, I2=98.1%) and 11% (95% CI 9 to 14, I2=97.4%), respectively. CONCLUSION: Attainment of optimal diabetes treatment goals, especially HbA1c, in adult patients with type 2 diabetes in Africa remains a challenge. Diabetes complications, especially diabetic peripheral neuropathy and retinopathy, are highly prevalent in adult populations with type 2 diabetes in Africa

Burden and associated phenotypic characteristics of tuberculosis infection in adult Africans with diabetes: a systematic review.

Diabetes mellitus (DM) increases the risk of developing tuberculosis infection (TBI). However, the evidence on the burden and phenotypic characteristics of TBI in African patients with DM is limited. This study aimed to determine the prevalence and characterisation of TBI in native African patients living with DM. We searched PubMed, EMBASE, and African Journals Online for original studies reporting information on the prevalence and characteristics of TBI in adult Africans with DM. A forest plot was used to describe the pooled prevalence estimate of TBI and the corresponding 95% confidence intervals (CI). Six studies conducted in four African countries involving 721 participants with DM were included in this systematic review. The pooled prevalence estimate of TBI was 40% (95% CI 20-60%, I2 = 98.52%, p < 0.001). Age ≥ 40 years and glycated haemoglobin levels independently predicted TBI positivity in patients with DM in three studies. Africans with DM have a high prevalence of TBI, especially those who are older or with poorly controlled diabetes. This justifies the need for studies to explore how to screen and manage TBI to avert the progression to active TB disease

The gut microbiota: a major player in the toxicity of environmental pollutants?

Exposure to environmental chemicals has been linked to various health disorders, including obesity, type 2 diabetes, cancer and dysregulation of the immune and reproductive systems, whereas the gastrointestinal microbiota critically contributes to a variety of host metabolic and immune functions. We aimed to evaluate the bidirectional relationship between gut bacteria and environmental pollutants and to assess the toxicological relevance of the bacteria–xenobiotic interplay for the host. We examined studies using isolated bacteria, faecal or caecal suspensions—germ-free or antibiotic-treated animals—as well as animals reassociated with a microbiota exposed to environmental chemicals. The literature indicates that gut microbes have an extensive capacity to metabolise environmental chemicals that can be classified in five core enzymatic families (azoreductases, nitroreductases, β-glucuronidases, sulfatases and β-lyases) unequivocally involved in the metabolism of >30 environmental contaminants. There is clear evidence that bacteria-dependent metabolism of pollutants modulates the toxicity for the host. Conversely, environmental contaminants from various chemical families have been shown to alter the composition and/or the metabolic activity of the gastrointestinal bacteria, which may be an important factor contributing to shape an individual’s microbiotype. The physiological consequences of these alterations have not been studied in details but pollutant-induced alterations of the gut bacteria are likely to contribute to their toxicity. In conclusion, there is a body of evidence suggesting that gut microbiota are a major, yet underestimated element that must be considered to fully evaluate the toxicity of environmental contaminants