Armed violence and rural livelihoods

This briefing paper examines relationships between armed violence affecting rural communities and efforts to maintain, restore and promote already fragile livelihoods. It is one of a series of briefings addressing issues surrounding the interaction between armed violence and poverty-reducing development. This paper seeks to provide an introduction for the staff of the UK government¿s Department for International Development (DFID) and other donor agencies to some of the issues raised in trying to make this connection and to stimulate thinking on these questions in analysis and policy. Some of the key questions to be addressed are: ¿ How can DFID¿s current sustainable rural livelihoods framework be applied to contexts of armed violence? ¿ What are the implications of these relationships for planning and programming rural development? ¿ Conversely, how might development interventions tackle the prevalence and spread of Small Arms and Light Weapons (SALW) and other factors fostering violence that affect livelihood

Proximate composition and vitamin a contribution of biofortified orange fleshed sweet potato value added products

Orange fleshed sweet potato (OFSP) is rich in provitamin A carotenoids and can thus be utilized to tackle Vitamin A deficiency (VAD) in Sub-Saharan Africa (SSA). Puree with high amounts of β-carotene processed from OFSP roots is currently being incorporated in baked products such as bread, cakes, biscuits, and buns. The objective of this study was to evaluate the nutritional composition of OFSP puree supplemented food products, that is, bread, buns, flakes, cakes, biscuits, muffins, soft cookies, golden biscuits and whole wheat flour bread. The composite products made from OFSP puree were analyzed for β-carotene content and proximate analysis. The highest concentration of β-carotene (19.86 mg/100g) was obtained in OFSP flakes. The concentration in buns with 20% puree was 0.58 mg/100g, while bread with 35% puree had a concentration of 3.02 mg/100g. Biscuits, cookies and cakes with high puree of 40% had β-carotene concentrations of 2.39, 1.83, and 2.30 mg/100g respectively. These concentrations are lower than in bread with 35% puree, and we see different proportions of ingredients and other factors such as cooking method, duration of cooking also play a major role in the final β-carotene concentration of the products. The total Retinol Activity Equivalents (RAE) for the OFSP products were significantly different with bread (35% puree) having a higher concentration of 216.67 μg/100g and OFSP buns (20% puree) having a lower concentration of 41.19 μg/100g. Orange fleshed sweet potato flakes had the highest concentration of 1443.2 μg/100g and whole wheat flour bread having the least of 6.9 μg/100g. The moisture content, total ash, crude fiber, crude fat, crude protein, and carbohydrate content of the OFSP products varied between 2.4-29.7%, 0.7-2.4%, 1.0-4.5%, 0.7-18.1%, 5.1-7.9% and 50.7-83.7%, respectively. The findings of this study show that different proportions of OFSP puree: wheat flour is not the only determinant on the final β-carotene concentration of the different OFSP products, the type and quantity of ingredients used, cooking time and method also contribute to the VA content. Diversification of OFSP food products helps increase its consumption and its added value.&nbsp

Moving barriers, increasing access: an assessment of the mobility of women with disabilities and elderly women

Papers presented virtually at the 41st International Southern African Transport Conference on 10-13 July 2023.The success of Sustainable Development Goal 11, particularly target 11.2 on access to safe, affordable, and sustainable transport systems will be measured through the proportion of people especially vulnerable groups with access to convenient public transport systems. In Kenya, this demographic group comprises 2.2% (0.9 million) of people with disabilities and 6% (2.7 million) of the elderly. Among these statistics, women form the largest proportion; 2.5% for people with disabilities and 55% for the elderly. The purpose of this assessment is hence to understand the vulnerabilities women with disabilities and elderly women face in accessing public transport through documenting their subjective experiences, with a special focus on Nairobi City County. A mixed methodology approach was adopted comprising a survey targeting women with disabilities and elderly women to collect data; Focus Group Discussions; and Key Informant Interviews with transport policymakers, public transport operators and owners, and relevant government institutions. Findings from the study indicate that women with disabilities and elderly women currently face challenges in accessing public transport services due to a lack of inclusive national and county transport policies, inaccessible design of public transport vehicles and infrastructure, unaffordable and hidden costs of transport, vulnerability to sexual harassment, limited road safety, and security; inaccessible travel information; discrimination, unresponsive reporting mechanisms, and a non-representative workforce. To enhance access to public transport for these vulnerable groups, the study recommends technical, social, and institutional interventions, including implementation of the Public Service Vehicle standard designs in Kenya to ensure inclusive accessibility, education and awareness programs to public service operators on handling and treatment of vulnerable groups, sensitization and implementation of policies governing vulnerable groups and building capacity of women belonging to these groups on self-advocacy

A longitudinal analysis of the vaginal microbiota and vaginal immune mediators in women from sub-Saharan Africa

In cross-sectional studies increased vaginal bacterial diversity has been associated with vaginal inflammation which can be detrimental for health. We describe longitudinal changes at 5 visits over 8 weeks in vaginal microbiota and immune mediators in African women. Women (N = 40) with a normal Nugent score at all visits had a stable lactobacilli dominated microbiota with prevailing Lactobacillus iners. Presence of prostate-specific antigen (proxy for recent sex) and being amenorrhoeic (due to progestin-injectable use), but not recent vaginal cleansing, were significantly associated with microbiota diversity and inflammation (controlled for menstrual cycle and other confounders). Women (N = 40) with incident bacterial vaginosis (Nugent 7-10) had significantly lower concentrations of lactobacilli and higher concentrations of Gardnerella vaginalis, Atopobium vaginae, and Prevotella bivia, at the incident visit and when concentrations of proinflammatory cytokines (IL-1β, IL-12p70) were increased and IP-10 and elafin were decreased. A higher 'composite-qPCR vaginal-health-score' was directly associated with decreased concentrations of proinflammatory cytokines (IL-1α, IL-8, IL-12(p70)) and increased IP-10. This longitudinal study confirms the inflammatory nature of vaginal dysbiosis and its association with recent vaginal sex and progestin-injectable use. A potential role for proinflammatory mediators and IP-10 in combination with the vaginal-health-score as predictive biomarkers for vaginal dysbiosis merits further investigation

Induction of humoral immune response to multiple recombinant Rhipicephalus appendiculatus antigens and their effect on tick feeding success and pathogen transmission

BACKGROUND: Rhipicephalus appendiculatus is the primary vector of Theileria parva, the etiological agent of East Coast fever (ECF), a devastating disease of cattle in sub-Saharan Africa. We hypothesized that a vaccine targeting tick proteins that are involved in attachment and feeding might affect feeding success and possibly reduce tick-borne transmission of T. parva. Here we report the evaluation of a multivalent vaccine cocktail of tick antigens for their ability to reduce R. appendiculatus feeding success and possibly reduce tick-transmission of T. parva in a natural host-tick-parasite challenge model. METHODS: Cattle were inoculated with a multivalent antigen cocktail containing recombinant tick protective antigen subolesin as well as two additional R. appendiculatus saliva antigens: the cement protein TRP64, and three different histamine binding proteins. The cocktail also contained the T. parva sporozoite antigen p67C. The effect of vaccination on the feeding success of nymphal and adult R. appendiculatus ticks was evaluated together with the effect on transmission of T. parva using a tick challenge model. RESULTS: To our knowledge, this is the first evaluation of the anti-tick effects of these antigens in the natural host-tick-parasite combination. In spite of evidence of strong immune responses to all of the antigens in the cocktail, vaccination with this combination of tick and parasite antigens did not appear to effect tick feeding success or reduce transmission of T. parva. CONCLUSION: The results of this study highlight the importance of early evaluation of anti-tick vaccine candidates in biologically relevant challenge systems using the natural tick-host-parasite combination

Maternal anaemia and duration of zidovudine in antiretroviral regimens for preventing mother-to-child transmission: a randomized trial in three African countries

Background: Although substantiated by little evidence, concerns about zidovudine-related anaemia in pregnancy have influenced antiretroviral (ARV) regimen choice for preventing mother-to-child transmission of HIV-1, especially in settings where anaemia is common. Methods: Eligible HIV-infected pregnant women in Burkina Faso, Kenya and South Africa were followed from 28 weeks of pregnancy until 12–24 months after delivery (n = 1070). Women with a CD4 count of 200-500cells/mm3 and gestational age 28–36 weeks were randomly assigned to zidovudine-containing triple-ARV prophylaxis continued during breastfeeding up to 6-months, or to zidovudine during pregnancy plus single-dose nevirapine (sd-NVP) at labour. Additionally, two cohorts were established, women with CD4 counts: \u3c200 cells/mm3 initiated antiretroviral therapy, and \u3e500 cells/mm3 received zidovudine during pregnancy plus sd-NVP at labour. Mild (haemoglobin 8.0-10.9 g/dl) and severe anaemia (haemoglobin \u3c 8.0 g/dl) occurrence were assessed across study arms, using Kaplan-Meier and multivariable Cox proportional hazards models. Results: At enrolment (corresponded to a median 32 weeks gestation), median haemoglobin was 10.3 g/dl (IQR = 9.2-11.1). Severe anaemia occurred subsequently in 194 (18.1%) women, mostly in those with low baseline haemoglobin, lowest socio-economic category, advanced HIV disease, prolonged breastfeeding (≥6 months) and shorter ARV exposure. Severe an- aemia incidence was similar in the randomized arms (equivalence P-value = 0.32). After 1–2 months of ARV’s, severe anaemia was significantly reduced in all groups, though remained highest in the low CD4 cohort. Conclusions: Severe anaemia occurs at a similar rate in women receiving longer triple zidovudine-containing regimens or shorter prophylaxis. Pregnant women with pre-existing anaemia and advanced HIV disease require close monitoring

Longitudinal analysis reveals that delayed bystander CD8+ T cell activation and early immune pathology distinguish severe COVID-19 from mild disease

The kinetics of the immune changes in COVID-19 across severity groups have not been rigorously assessed. Using immunophenotyping, RNA sequencing, and serum cytokine analysis, we analyzed serial samples from 207 SARS-CoV2-infected individuals with a range of disease severities over 12 weeks from symptom onset. An early robust bystander CD8+ T cell immune response, without systemic inflammation, characterized asymptomatic or mild disease. Hospitalized individuals had delayed bystander responses and systemic inflammation that was already evident near symptom onset, indicating that immunopathology may be inevitable in some individuals. Viral load did not correlate with this early pathological response but did correlate with subsequent disease severity. Immune recovery is complex, with profound persistent cellular abnormalities in severe disease correlating with altered inflammatory responses, with signatures associated with increased oxidative phosphorylation replacing those driven by cytokines tumor necrosis factor (TNF) and interleukin (IL)-6. These late immunometabolic and immune defects may have clinical implications

Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2

Although two-dose mRNA vaccination provides excellent protection against SARS-CoV-2, there is little information about vaccine efficacy against variants of concern (VOC) in individuals above eighty years of age1. Here we analysed immune responses following vaccination with the BNT162b2 mRNA vaccine2 in elderly participants and younger healthcare workers. Serum neutralization and levels of binding IgG or IgA after the first vaccine dose were lower in older individuals, with a marked drop in participants over eighty years old. Sera from participants above eighty showed lower neutralization potency against the B.1.1.7 (Alpha), B.1.351 (Beta) and P.1. (Gamma) VOC than against the wild-type virus and were more likely to lack any neutralization against VOC following the first dose. However, following the second dose, neutralization against VOC was detectable regardless of age. The frequency of SARS-CoV-2 spike-specific memory B cells was higher in elderly responders (whose serum showed neutralization activity) than in non-responders after the first dose. Elderly participants showed a clear reduction in somatic hypermutation of class-switched cells. The production of interferon-γ and interleukin-2 by SARS-CoV-2 spike-specific T cells was lower in older participants, and both cytokines were secreted primarily by CD4 T cells. We conclude that the elderly are a high-risk population and that specific measures to boost vaccine responses in this population are warranted, particularly where variants of concern are circulating