RANDOMISED DOUBLE BLIND STUDY TO COMPARE EFFECTIVENESS OF HONEY, SALBUTAMOL AND PLACEBO IN TREATMENT OF COUGH IN CHILDREN WITH COMMON COLD

Background: Acute upper respiratory infection is the most common childhood illness and presents with cough, coryza and fever. Available evidence suggests that cough medicines may be no more effective than honey-based cough remedies. Objective: To compare effectiveness of honey, salbutamol and placebo in the treatment of cough in children with acute onset cough. Design: Randomised control trial Setting: Aga Khan University Hospital Paediatric Casualty Subjects: Children between ages one to twelve years presenting with a common cold between December 2010 and February 2012 were enrolled. Outcome measures: Frequency, severity and extent to which cough bothered and disturbed child and parental sleep were assessed at baseline and over the subsequent five days through telephone interview using a validated scoring tool. Results: One hundred and forty five children were enrolled in the study (45- placebo, 57 –honey, 43 –salbutamol). Of the 145 children 51% were male. Honey significantly reduced the total mean symptom score by day three (p\u3c 0.001). Total mean difference in scores between day zero to five demonstrated a significant difference of honey’s efficacy over placebo (p\u3c 0.002) however no difference was noted when compared to salbutamol (p\u3c0.478). Significant differences in both total as well as each individual symptom score was detected with honey consistently scoring the best whilst placebo and salbutamol scored the worst. In paired comparisons honey was superior to placebo but not salbutamol, whilst salbutamol was not superior to placebo. Conclusion: Honey was most effective in symptomatic relief of symptoms associated with the common cold whilst salbutamol or placebo offered no benefit

A review on the contribution of crop diversification to Sustainable Development Goal 1 “No poverty” in different world regions

I am grateful to Professor Maggie Gill and Dr Leslie Lipper for initial discussions, to Dr Leslie Lipper for arranging the meetings with the experts at the Food and Agriculture Organization (FAO) and to the experts at FAO for the valuable discussions on the topic. I would also like to thank Kirsten MacSween for revising the English. This research has been funded by the UK Natural Environment Research Council (NERC), NE/N005619/1.Peer reviewedPublisher PD

Aflatoxin contamination of maize and groundnut in Burundi: distribution of contamination, identification of causal agents and potential biocontrol genotypes of Aspergillus flavus

Open Access JournalAflatoxin contamination of the staples maize and groundnut is a concern for health and economic impacts across sub-Saharan Africa. The current study (i) determined aflatoxin levels in maize and groundnut collected at harvest in Burundi, (ii) characterized populations of Aspergillus section Flavi associated with the two crops, and (iii) assessed aflatoxin-producing potentials among the recovered fungi. A total of 120 groundnut and 380 maize samples were collected at harvest from eight and 16 provinces, respectively. Most of the groundnut (93%) and maize (87%) contained aflatoxin below the European Union threshold, 4 μg/kg. Morphological characterization of the recovered Aspergillus section Flavi fungi revealed that the L-morphotype of A. flavus was the predominant species. Aflatoxin production potentials of the L-morphotype isolates were evaluated in maize fermentations. Some isolates produced over 137,000 μg/kg aflatoxin B 1 . Thus, despite the relatively low aflatoxin levels at harvest, the association of both crops with highly toxigenic fungi poses significant risk of post-harvest aflatoxin contamination and suggests measures to mitigate aflatoxin contamination in Burundi should be developed. Over 55% of the L-morphotype A. flavus did not produce aflatoxins. These atoxigenic L-morphotype fungi were characterized using molecular markers. Several atoxigenic genotypes were detected across the country and could be used as biocontrol agents. The results from the current study hold promise for developing aflatoxin management strategies centered on biocontrol for use in Burundi to reduce aflatoxin contamination throughout the value chain

Supporting community-based natural resource management in pastoralist societies in East Africa to achieve the UN Sustainable Development Goals

This is the final published report.Sustainable pastoralism provides a wide range of economic, social and ecological value. However, the sustainability of this global food system has been undermined by systemic low investment. The effects of inappropriate development policies, growing population pressure and escalating economic inequalities are all being exacerbated by the increasing climate variability over the past decades. In recent years, community-based natural resource management (CBNRM) has emerged as a potential solution to these challenges. Rangeland areas may be managed more effectively by enabling communities to develop more sustainable livestock practices, restore the quality of rangelands and ecosystem services, improve the quality and market value of livestock, and ultimately aim to increase food security while reducing social inequalities. Such community-based management of economically, socially and ecologically important areas of land therefore addresses at least nine Sustainable Development Goals (SDGs). Here, we outline the challenges facing pastoral systems, how CBNRM provides a potential solution, and the link between pastoral CBNRM and the SDGs. Our collaborative and interdisciplinary research network aims to provide context-driven evidence for pastoral CBNRM that will ultimately underpin co-designed sustainable land management strategies.University of Exeter’s Global Challenges Research Fund (GCRF

Selecting sites to prove the concept of IAR4D in the Lake Kivu Pilot Learning Site

Selecting sites is an essential step in enabling the assessment of the impact of Integrated Agricultural Research for Development (IAR4D) in the Lake Kivu Pilot Learning Site. This paper reports on the process of identifying distinct administrative territories (sites) in which to establish innovation platforms and to monitor similar communities that are experiencing alternative agricultural research for development interventions. We show how the research design for the Sub- Saharan Africa Challenge Programme (SSACP) has been modified to take into account the key conditioning factors of the LKPLS without relinquishing robustness. A key change is the explicit incorporation of accessibility to multiple markets. Candidate sites were stratified according to the national political context, followed by good and poor accessibility to markets and finally according to security considerations and agro-ecology. Randomisation was carried out at all levels, although the need for paired counterfactual sites required the diagnosis of conditioning factors at the site level. Potential sites were characterised in terms of existing or recent agricultural research initiatives, as well as local factors that would have a direct effect on the success of interventions seeking to improve productivity, ameliorate the degradation of natural resources and enhance incomes through better links to markets. Fourteen sites were selected during the initial phase, and a further ten sites were added one year afterwards due to the need for more innovation platforms to test IAR4D. The site selection was successful in pairing action and counterfactual sites in terms of the baseline socioeconomic conditions of farming households. The unavoidable proximity of action and counterfactual sites, however, allows the possibility of spill-over effects and could reduce the measurable impact of IAR4D

What constitutes responsiveness of physicians: A qualitative study in rural Bangladesh

Responsiveness entails the social actions by health providers to meet the legitimate expectations of patients. It plays a critical role in ensuring continuity and effectiveness of care within people centered health systems. Given the lack of contextualized research on responsiveness, we qualitatively explored the perceptions of outpatient users and providers regarding what constitute responsiveness in rural Bangladesh. An exploratory study was undertaken in Chuadanga, a southwestern Bangladeshi District, involving in-depth interviews of physicians (n = 17) and users (n = 7), focus group discussions with users (n = 4), and observations of patient provider interactions (three weeks). Analysis was guided by a conceptual framework of responsiveness, which includes friendliness, respecting, informing and guiding, gaining trust and optimizing benefits. In terms of friendliness, patients expected physicians to greet them before starting consultations; even though physicians considered this unusual. Patients also expected physicians to hold social talks during consultations, which was uncommon. With regards to respect patients expected physicians to refrain from disrespecting them in various ways; but also by showing respect explicitly. Patients also had expectations related to informing and guiding: they desired explanation on at least the diagnosis, seriousness of illness, treatment and preventive steps. In gaining trust, patients expected that physicians would refrain from illegal or unethical activities related to patients, e.g., demanding money against free services, bringing patients in own private clinics by brokers (dalals), colluding with diagnostic centers, accepting gifts from pharmaceutical representatives. In terms of optimizing benefits: patients expected that physicians should be financially sensitive and consider individual need of patients. There were multiple dimensions of responsiveness- for some, stakeholders had a consensus; context was an important factor to understand them. This being an exploratory study, further research is recommended to validate the nuances of the findings. It can be a guideline for responsiveness practices, and a tipping point for future research