Bioscience data literacy at the interface of the environment, human and wildlife : one health-centred education, research and practice perspectives in Rwanda

Advances in information technology have led to the availability of state-of-the-art technologies which in turn have been enabling the generation of unprecedented amounts of complex, structured or unstructured data sets that are sometimes difficult to process using conventional techniques. In particular, handling these large scale data in terms of collection, and aggregation, synthesis and analysis, interpretation, reporting, sharing and archiving processes, and interpreting them into descriptive models and enable effective interpretation requires continued development of robust computational models, algorithms and interoperable analytical frameworks (Hampton et al. 2017). This also involves the vital availability of data management expertise and reflects an imperative need for data science professionals, especially in the context of generating the most informative data for use and drive evidence-based decisions. Considering this, Rwanda has been fueling its economic transformation agenda, and, while this solely depends on natural resources exploitation, the scenario has led to critically concerning anthropogenic threats and unprecedented environmental vulnerability. Acknowledging the urgency to achieve its development needs while at the same time safeguarding the environmental sustainability, Rwanda has been promoting technology-enabled systems and approaches for sustainable management of environment and natural resources. Learning from global initiatives, Rwanda's journey targets the effective use of technology-supported systems and data science expertise to effectively drive management and decision making needs in environmental management, health research systems and biodiversity conservation planning (Karame et al. 2017). Rwanda champions the adoption and effective use of technology towards delivering its vision of knowledge-based economy. A particular emphasis relates to streamlining the education, research and application of technology-supported systems and platforms and strengthening their effective use. From a practical One Health perspective, Rwanda has been bridging inter-sectoral gaps related to joint planning and resource sharing for informed decision processes. This One Health concept emphasizes the interconnection of the health of human, animals and ecosystems and involves the applications of multidisciplinary, coordinated, cross-sectoral collaborative efforts to attain optimal health for people, animals and the environment (Buttke et al. 2015). One Health constitutes a promising approach in the advancement of biosciences. For example, big data and ecological and digital epidemiology analysis has led to promising progress beyond the traditional transdisciplinary conservation medicine approach, and One Health is now driving solutions to major conservation and health challenges. This paper aims to explore the perspectives of solving challenges in handling heterogeneous data and sources of uncertainty, the progress and feasibility of adopting (or developing, adapting and customizing) open code- and data-sharing platforms, and integrating the application of flexible statistical models and cloud-computing, all within the confines of limited resources. Africa needs to engage in data science to build and sustain capacity and to effectively use acquired knowledge and skills. Further, Africa can strategically align and tailor existing technology data science platforms to the unique context of this continent. It is time to assess the boundaries, explore new horizons, and reach beyond the limits of current practice in order to enable researchers to get the most from generated data. We envision a long-term integrative and digital approach to handling and processing health, environment, and wildlife data to mark the beginning of our journey forward

OC 8526 THE RWANDA CLINICAL RESEARCH NETWORK (RWANDA-CRN): A MODEL FOR MIXED SOUTH-SOUTH AND NORTH-SOUTH COLLABORATIONS FOR CLINICAL RESEARCH CAPACITY DEVELOPMENT

BackgroundPoor countries carry 90% of the global burden of disease, with access to only 10% of globally available health research funding and technical capacity. Fragile south–south collaborations hinder effective use of limited resources, career opportunities and funding to retain the insufficiently available quality scientists. The Rwanda Health System established a clinical research network involving academia, non-governmental organisations and private sector to accelerate generation of talented scientists, create enabling environment and incentives to retain scientists by establishing a local funding model.MethodsBased on a baseline assessment, potential clinical trial units were mapped and developed through adoption of a Clinical trial management training model from European Universities. The Rwandan law on Public Private Partnership was leveraged to attract and engage local and international private players in a win-win approach. So far, countries such as Kenya and Sweden were engaged in the roadmap.ResultsFrom 2014 to date, a total of 285 scientists are trained on various clinical research components: Good Clinical Practice (28%), Research Grant writing (14%), systematic review and meta-analysis (9%) and scientific communication (8.7%). Ten Clinical Research Units and one centre for evidence-based healthcare were established. So far 13 health investigator-initiated projects in malaria, metabolic disorders and maternal health were funded through the local funding model. A process to empower six malaria sentinel sites into fully functioning clinical research sites is underway.ConclusionThe creation of strong networks of excellence forclinical research among southern academic, research institutions and pharmaceutical and non-pharmaceutical industry is a promising strategic approach to promote sustainable clinical research capacity. The government vision is that beyond national boundaries, resource sharing and involvement of private players are key factors to mitigate the high burden of disease, nationally and regionally.</jats:sec

Epidemiology of sexually transmitted infections: trends among patients screened for sexually transmitted infections in rwandan health facilities 2014–2020

Background Sexually Transmitted Infections (STIs) are of great global health concern. Currently, there are limited epidemiological data characterizing STIs in the general population in Rwanda. We assessed the national and regional epidemiology of STIs in Rwanda from 2014–2020 among patients syndromically screened for STIs in all health facilities in Rwanda. Methods This is a retrospective analysis of the trend of STIs epidemiology among screened patients at all health facilities in Rwanda using data from the Health Management Information System (HMIS) reporting. Adult patients (15 years and over) screened for STIs between July 2014 and June 2020 were included in the analysis. Outcomes of interest were the number of individuals screened for STIs and individuals diagnosed with at least one STI with a syndromic approach only or plus a test together. Results Overall, the number of individuals screened for STIs over the study period was 5.3 million (M) in 2014–2015, 6.6 M in 2015–2016, 6.3 M in 2016–2017, 6.7 M in 2017–2018, 6.2 M in 2018–2019, and 4.9 M in 2019–2020. There was a modest increase in the number of individuals diagnosed and treated for STIs from 139,357 in 2014–15 to 202,294 (45% increase) in 2019–2020. At the national level, the prevalence of STI syndromes amongst individuals screened at health facilities in Rwanda varied between 2.37% to 4.16% during the study period. Among the provinces, Kigali city had the highest prevalence for the whole 6 years ranging from 3.46% (95%CI: 3.41, 3.51) in 2014–2015 to 8.23% (95%CI: 8.15, 8.31) in 2019–2020. Conclusion From 2014 to 2020, the number of patients screened for STI syndromes in Rwanda varied between 4.9 M and 6.7 M. However, the prevalence of STIs among screened patients increased considerably over time, which could be associated with public awareness and improved data recording. The highest prevalence of all STIs was observed in urban areas and near borders, and private clinics reported more cases, suggesting the need to improve awareness in these settings and increase confidentiality and trust in public health clinics.Medicine, Faculty ofNon UBCPopulation and Public Health (SPPH), School ofReviewedFacultyResearche