Getting into hot water: water quality in tropical lakes in relation to their utilisation

Over-exploitation of tropical lakes and reservoirs ('lakes') causes water quality problems that occur as a result of competing socio-economic demands and the presence of feedback loops within the system that exacerbate the situation. We review well documented case studies from Brazil, India, Indonesia, Kenya, Malaysia and Mexico to examine the effect that changes in water quality and quantity have had on the utilisation of these tropical lakes. By comparing the different approaches used to improve their sustainable management, we have found that nutrient enrichment is one of the most important and widespread water quality problems, causing adverse effects such as algal blooms, nuisance levels of aquatic plants, low oxygen levels and elevated greenhouse gas emissions. These effects restrict the use of these lakes for water supply, fisheries, recreation, tourism and wildlife. We conclude that tropical lakes require better management, urgently, to restore the ecosystem services that they deliver to man and nature. However, to be effective, the development of sustainable management programmes needs to be underpinned by reliable scientific evidence and the results of extensive stakeholder engagement activities. We note that, currently, there is little information available on how tropical lakes respond to management interventions that can be used to guide these activities. Further research is needed to address this knowledge gap. Presented at International Conference on the Ocean and Earth Sciences, 18-20 November 2020, Jakarta Selatan, Indonesia (held online)

Beaten but not down! Exploring resilience among female sex workers (FSWs) in Nairobi, Kenya

Background: In Kenya sex work is illegal and those engaged in the trade are stigmatized and marginalized. We explored how female sex workers in Nairobi, Kenya, utilize different resources to navigate the negative consequences of the work they do. Methods: Qualitative data were collected in October 2019 from 40 FSWs who were randomly sampled from 1003 women enrolled in the Maisha Fiti study, a 3-year longitudinal mixed-methods study exploring the relationship between HIV risk and violence and mental health. All interviews were audio-recorded, transcribed and translated. Data were thematically coded and analyzed using Nvivo 12. Results: Participants’ age range was 18–45 years. Before entry into sex work, all but one had at least one child. Providing for the children was expressed as the main reason the women joined sex work. All the women grew up in adverse circumstances such as poor financial backgrounds and some reported sexual and physical abuse as children. They also continued to experience adversity in their adulthood including intimate partner violence as well as violence at the workplace. All the participants were noted to have utilised the resources they have to build resilience and cope with these adversities while remaining hopeful for the future. Motherhood was mentioned by most as the reason they have remained resilient. Coming together in groups and engaging with HIV prevention and treatment services were noted as important factors too in building resilience. Conclusion: Despite the adverse experiences throughout the lives of FSWs, resilience was a key theme that emerged from this study. A holistic approach is needed in addressing the health needs of female sex workers. Encouraging FSWs to come together and advocating together for their needs is a key resource from which resilience and forbearance can grow. Upstream prevention through strengthening of education systems and supporting girls to stay in school and complete their secondary and/or tertiary education would help them gain training and skills, providing them with options for income generation during their adult lives

Conducting Violence and Mental Health Research with Female Sex Workers during the COVID-19 Pandemic: Ethical Considerations, Challenges, and Lessons Learned from the Maisha Fiti Study in Nairobi, Kenya

Conducting violence and mental health research during the COVID-19 pandemic with vulnerable groups such as female sex workers (FSWs) required care to ensure that participants and the research team were not harmed. Potential risks and harm avoidance needed to be considered as well as ensuring data reliability. In March 2020, COVID-19 restrictions were imposed in Kenya during follow-up data collection for the Maisha Fiti study (n = 1003); hence data collection was paused. In June 2020, the study clinic was re-opened after consultations with violence and mental health experts and the FSW community. Between June 2020 and January 2021, data were collected in person and remotely following ethical procedures. A total of 885/1003 (88.2%) FSWs participated in the follow-up behavioural–biological survey and 47/47 (100%) participated in the qualitative in-depth interviews. A total of 26/885 (2.9%) quantitative surveys and 3/47 (6.4%) qualitative interviews were conducted remotely. Researching sensitive topics like sex work, violence, and mental health must guarantee study participants’ safety and privacy. Collecting data at the height of COVID-19 was crucial in understanding the relationships between the COVID-19 pandemic, violence against women, and mental health. Relationships established with study participants during the baseline survey—before the pandemic—enabled us to complete data collection. In this paper, we discuss key issues involved in undertaking violence and mental health research with a vulnerable population such as FSWs during a pandemic. Lessons learned could be useful to others researching sensitive topics such as violence and mental health with vulnerable populations

Violence across the Life Course and Implications for Intervention Design: Findings from the Maisha Fiti Study with Female Sex Workers in Nairobi, Kenya

We examined violence experiences among Female Sex Workers (FSWs) in Nairobi, Kenya, and how these relate to HIV risk using a life course perspective. Baseline behavioural–biological surveys were conducted with 1003 FSWs June-December 2019. Multivariable logistic regression models were used to estimate the adjusted odds ratio (AOR) and 95% confidence intervals (CI) for associations of life course factors with reported experience of physical or sexual violence in the past 6 months. We found substantial overlap between violence in childhood, and recent intimate and non-intimate partner violence in adulthood, with 86.9% reporting one or more types of violence and 18.7% reporting all three. Recent physical or sexual violence (64.9%) was independently associated with life course factors, including a high WHO Adverse Childhood Experiences (ACE) score (AOR = 7.92; 95% CI:4.93–12.74) and forced sexual debut (AOR = 1.97; 95% CI:1.18–3.29), as well as having an intimate partner (AOR = 1.67; 95% CI:1.25–2.23), not having an additional income to sex work (AOR = 1.54; 95% CI:1.15–2.05), having four or more dependents (AOR = 1.52; 95% CI:0.98–2.34), recent hunger (AOR = 1.39; 95% CI:1.01–1.92), police arrest in the past 6 months (AOR = 2.40; 95% CI:1.71–3.39), condomless last sex (AOR = 1.46; 95% CI:1.02–2.09), and harmful alcohol use (AOR = 3.34; 95% CI:1.74–6.42). Interventions that focus on violence prevention during childhood and adolescence should help prevent future adverse trajectories, including violence experience and HIV acquisition

Protection Versus Pathology in Aviremic and High Viral Load HIV-2 Infection—The Pivotal Role of Immune Activation and T-cell Kinetics

BACKGROUND: Many human immunodeficiency virus (HIV)-2-infected individuals remain aviremic and behave as long-term non-progressors but some progress to AIDS. We hypothesized that immune activation and T-cell turnover would be critical determinants of non-progressor/progressor status. METHODS: We studied 37 subjects in The Gambia, West Africa: 10 HIV-negative controls, 10 HIV-2-infected subjects with low viral loads (HIV-2-LV), 7 HIV-2-infected subjects with high viral loads (HIV-2-HV), and 10 with HIV-1 infection. We measured in vivo T-cell turnover using deuterium-glucose labeling, and correlated results with T-cell phenotype (by flow cytometry) and T-cell receptor excision circle (TREC) abundance. RESULTS: Immune activation (HLA-DR/CD38 coexpression) differed between groups with a significant trend: controls <HIV-2-LV <HIV-1 <HIV-2-HV (P < .01 for all cell types). A similar trend was observed in the pattern of in vivo turnover of memory CD4(+) and CD8(+) T-cells and TREC depletion in naive CD4(+) T-cells, although naive T-cell turnover was relatively unaffected by either infection. T-cell turnover, immune activation, and progressor status were closely associated. CONCLUSIONS: HIV-2 non-progressors have low rates of T-cell turnover (both CD4(+) and CD8(+)) and minimal immune activation; high viral load HIV-2 progressors had high values, similar to or exceeding those in HIV-1 infection

Response of fish stocks in Lake Victoria to enforcement of the ban on illegal fishing:are there lessons for management?

Most small-scale inland fisheries in the Global South prohibit fishing gear with smaller meshes than is legally permitted. Nonetheless, in most instances, this is not strictly enforced. But starting in 2017, Uganda and Tanzania ramped up enforcement on Lake Victoria. We used time series hydro-acoustic data to determine whether the strict enforcement achieved the management goal of increased biomass (t) of commercial species and an increase in the biomass of big Nile perch (&gt;50 cm). The biomass for 2018–2021 (under strict enforcement) was expected to be greater than in 2007–2017 (prior to strict enforcement). The biomass of key species fluctuated annually, but no spatial or temporal differences in biomass associated with strict enforcement were evident. Similarly, the biomass of big Nile perch did not increase. Our findings suggest that mesh sizes may have limited influence on fish biomass dynamics in Lake Victoria, and that high primary productivity of the lake, high turnover rates of fish species, and limited compliance by fishers likely counteract the effects of high fishing effort on biomass and size structure of fish. Therefore, the high cost of strict top-down enforcement and the societal cost of lost lives, jobs, and livelihoods may not be justified